BACKGROUND: It is difficult to control an outbreak of Shigella infection, because of the ease of transmission and the resistance to multiple antibiotics. Recently, there were outbreaks of Shigella infection in Chinju area. The objective of this study was to investigate the molecular epidemiology of the outbreaks using pulsed-field gel electrophoresis(PFGE). METHOD: Thirteen S. flexneri strains, 25 S. sonnei strains from Chinju and 15 S. sonnei strains from Pusan were studied. All strains were isolated from stool cultures of diarrheal patients. Identification and antimicrobial susceptibility test those were tested by Vitek GNI and GNS-LH. Chromosomal DNA restricted with Xbal was resolved by PFGE. RESULT: All the S. flexneri strains and 23(92%)S. sonnei strains from Chinju were resistant to one or more antimicrobial agents. All the clinical isolates of S. flexneri showed the same PFGE pattern which was different from type strains(KTCC 2517). PFGE patterns of 25 (100%) S. sonnei strains from Chinju and 12 (80%) S. sonnei strains from Pusan were identical to those of type strain (KTCC 2009). Three S. sonnei strains from Pusan showed distinct PFGE patterns, respectively. CONCLUSION: PFGF demonstrated identical restriction pattern among most of Shigella isolates from Chinju and Pusan, indicating that an outbreak with genetically related strains had occurred. PFGE was useful in molecular epidemiology of Shigella outbreaks
Anti-Bacterial Agents ; Anti-Infective Agents ; Busan ; Disease Outbreaks ; DNA* ; Gyeongsangnam-do ; Humans ; Molecular Epidemiology ; Shigella

BACKGROUND: Portable devices for measuring peak expiratory flow(PEF) are now of proved value in the diagnosis and management of asthma and many lightweight PEF meters have become available. However, it is necessary to determine whether peak expiratory flow rate(PEFR) measurements measured with peak flowmeters is accurate and reproducible for clinical application. The aim of the present study is to define accuracy, agreement, and precision of mini-Wright peak flow meter(MPFM) against standard pneumotachygraph. METHODS: The lung function tests by standard pneumotachygraph and PEFR measurement by MPFM were performed in a random order for 2 hours in 22 normal and 17 asthmatic subjects and also were performed for 3 successive days in 22 normals. RESULTS: The PEFR measured with MPFM was significantly related to the PEFR and FEV1 measured with standard pneumotachygraph in normal and asthmatics(for PEFR, r=0.92 p<0.001; for FEV1, r=0.78 ; p<0.001). The accuracy of MPFM was within 10%(limits of accuracy recommeded by NAEP) in all the subjects or 22 normal, mean difference from standard pneumotachygraph being I 6.5L/min(percentage of difference being 2.90%) or 1 0.6L/min(percentage of difference being 1.75%), respectively. According to the method proposed by Bland and Altman, the 95% limits of the distribution of differences between MPFM and standard pneumotachygraph after correction of PEFR using our regression equation were +38.2 and -71.5L/min in all the subjects or -20.49~ + 9.49L/min in 22 normal and was similar to the intraindividual agreements for 3 successive days in normal. There was no statistically significant difference of PEFR measured with MPFM and standard pneumotachygraph among three days(p>0.05) and the coefficient of variation(2.4 1.2%) of PEFR measured with MPFM was significantly lower than that( 5.2 3.5%) with standard pneurnotachygraph in normal (p<0.05). CONCLUSION: This results suggest that the MPFM was as accurate and reproducible as standard pneumotachygraph for monitoring of PEFR in the asthmatic subjects.
Asthma ; Diagnosis ; Flowmeters ; Peak Expiratory Flow Rate ; Respiratory Function Tests

PURPOSE: This study was done to identify the relationship between nurses' compliance with safety guidelines for the use of antineoplastic agents, observable symptoms, and stress from occupational exposure. METHODS: The participants were 172 nurses from six general hospitals in a metropolitan area. They had administered antineoplastic agents at least three months prior to the study. Data were collected using self-report questionnaires, and then analyzed using SPSS/WIN 23.0 for descriptive statistics, t-test, one-way ANOVA, Scheffé method, and Pearson correlation coefficient. RESULTS: The average score on the guideline for safety compliance was 87.75 points out of a total of 100. The average score for observable symptoms of exposure to antineoplastic agents was 30.12 (28~56) points, and that for mean stress was 33.52 (15~60) points. Observable symptoms and stress from occupational exposure showed a statistically significant positive correlation (r=0.34, p < .001). CONCLUSION: To increase the degree of compliance with safety guidelines for antineoplastic agents, hospitals should lower the chance of exposure to antineoplastic agents, as well as minimize the observable symptoms and stress from occupational exposure. Periodic education and policy support are needed to improve compliance with safety guidelines for antineoplastic agent use.
Antineoplastic Agents* ; Compliance* ; Education ; Hospitals, General ; Methods ; Occupational Exposure*

Airway hyperresponsiveness is a consistent feature of asthma. Since the airway smooth muscle is hyperresponsive to a number of different stimuli operating through many different mechanisms, it is attractive to speculate that the abnormality may reside in the airway smooth muscle itself. Animal model of asthma is needed to unravel possible mechanisms underlying airway hyperresponsiveness and also to develop new therapeutic approaches. However, there are few reports showing that airway smooth muscle from animal asthma model is indeed hyperresponsive. In addition, sensitizing and provoking doses of allergen were different each other ambng the studies on animal asthma model. The aim of this study was to determine an appropriate sensitizing and provoking dose of allergen to induce a maximum airway hyperresponsiveness. Eighty-four male Sprague-Dawley rats were actively sensitized with a subcutaneous injection of 0, 10, or 1000/gg ovalbumin(OA) and 14 days later they were provoked with 0, 1, or 5 % OA aerosols. One day after the provocation, serum levels of OA-specific IgE, cell numbers in bronchoalveolar lavage fluid (BALF), and in vitro isometric contractile responses of the isolated tracheal smooth muscle(TSM) to 120 mM KC1, acetylcholine(ACh, 0.1~ 1000/micro meter), electrical field stimulation (EFS, 0.5~100Hz), serotonin(5-HT, 0.014 100/micro meter), and OA(10, 50, or 250 micro gram/ml) were measured. The results were as follows; 1) When 38 OA-sensitized rats were exposed to OA aerosols in vivo early asthmatic responses(EAR) were observed in 20(52.6%) rats. In vitro isometric contractile forces of TSM from rats with EAR were stronger than those from rats without EAR. 2) The maximal contractile responses to KC1 and EFS were significantly higher in rats only sensitized with OA compared with those in controls. The maximal response to ACh was significantly related to OA-specific serum IgE level(r=0.40, p%0.05), and the latter was in turn significantly related to the BALF eosinophil count(r=0.67, p<0.01). 3) When 10 microgram OA-sensitized rats were analyzed, the maximal response to KC1, ACh, EFS, and 250 micro gram/ml OA were lower in OA-provoked rats compared to those in saline-provoked control rats, in which 5% OA-provoked rats had a lower response than 1% OA-provoked rats. 4) The sensitivity of TSM to ACh was significantly higher in 10/micro gram OA-sensitized & OA-provoked rats, and the sensitivity to EFS was also significantly higher in 10/~g OA-sensitized & 5% OA-provoked rats compared to that in controls(p<0.05). 5) There was a significant correlation between the sensitivity of TSM to EFS and the counts of eosinophil or of lymphocytes in BALF(for eosinophil, r=-0.30; p<0.05, for lymphocyte, r=-0.35; p<0.05), or OA-specific serum IgE level(r=-0.46, p<0.01) in OA-sensitized & OA-provoked rats. This relationship was maintained in the data obtained only from 10 micro gram OA-sensitized & 5% OA-provoked rats. 6) The ratio of EFS-sensitivity to ACh-sensitivity was significantly lower in OA-sensitized & OA-provoked rats compared to that in controls or rats only sensitized with OA(p%0.05). 7) The Schultz-Dale phenomenon occurred in an in vitro dose-dependent manner. However, the inhaled provocation with OA in vivo resulted in a decrease in the contractile response to OA in vitro. There was a significant correlation between OA-specific serum IgE level and isometric response to 250 micro gram/ml OA(r=0.36, p<0.01). These results suggest that sensitization and provocation in vivo with OA in rats induces hypersensitivity of airway smooth muscle to cholinergic stimuli through an allergic inflammatory mechanism. The sensitivity was highest when sensitized to 10 micro gram OA and exposed to 5% OA aerosols.
Aerosols ; Animals ; Asthma* ; Bronchoalveolar Lavage Fluid ; Cell Count ; Ear ; Eosinophils ; Humans ; Hypersensitivity ; Immunoglobulin E ; Injections, Subcutaneous ; Lymphocytes ; Male ; Models, Animal ; Muscle, Smooth* ; Rats* ; Rats, Sprague-Dawley

No abstract available.

BACKGROUND/AIMS: Entecavir is a synthetic nucleoside analogue, cyclopentyl guanine nucleoside, which has a potent antiviral effect and the least viral breakthrough in hepatitis B virus (HBV) replication. Entecavir has been available in Korea since 2007 but there are few reports on its effects. The aim of this study was to evaluate the virological response (VR) and biochemical response (BR) to entecavir in HBV patients at 3, 6 and 9 months after treatment with entecavir. MATERIALS AND METHODS: Thirty-three chronic hepatitis B patients who took entecavir for at least 9 months were enrolled. We investigated VR and BR by retrospectively reviewing medical records. Patients who satisfied the following criteria were chosen: 1) initial alanine aminotransferase (ALT) levels = 1.5upper limit of normal (ULN) and 2) initial HBV DNA levels = 5 log10 copies/ml. We measured ALT levels every 3 months until month 9. HBV DNA was measured every 2 or 3 months by polymerase chain reaction (PCR) method. RESULTS: Most patients taking entecavir showed good BR (ALT < 40 IU/L). The BR rates were 61%, 73% and 67% at months 3, 6 and 9, respectively. VR (HBV DNA < 5 log(10) copies/ml or 2 log lower than initial HBV DNA) rates were 82%, 91% and 91% at months 3, 6 and 9, respectively. Undetectable HBV DNA (HBV DNA < 4 log(10) copies/ml) rates were 49%, 73% and 85% at months 3, 6 and 9, respectively. Two patients presented with virological breakthrough without adverse effects until month 9. CONCLUSIONS: Entecavir showed good BR and VR from month 3 and these effects continued through the 9-month observation period. This suggests that entecavir is also a good choice for the first line treatment of chronic hepatitis B (CHB). Further studies are needed to determine the long-term efficacy and drug resistance of entecavir in Korean CHB patients.
Alanine Transaminase ; DNA ; Drug Resistance ; Guanine ; Hepatitis B virus ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Korea ; Medical Records ; Polymerase Chain Reaction ; Retrospective Studies

This survey was conducted to find out one serving size and waste rate of frequently consumed dishes in 37 Korean style restaurants. The range of one serving size and waste rate of Pab(boiled rice) were 180~290g and 0~21%, respectively. The mean intakes of Pab were varied according to the kind of dishes served. The waste rate of Yukgaejang(Hot meat soup) is low among Tangban(meat soups). The waste rate of Jeongol(stew with various foods) was higher than other menu items. The average one serving size per person of Pulgogi(grilled meat with sauce), Galbi gui(grilled beef ribs with sauce), Deongsim gui(grilled meat) were 270g, 360g, and 210g, respectively. The average waste rate of side dishes were varied according to dist served. The dish which has higher waste rate than other dishes were Samgaetang(boiled chicken with ginseng), Bokmaeuntang(stew with puffer), Naengmyeun(cold noodle), Pulgogi(grilled meat with sauce), Galbi gui(frilled veef ribs). The reasonable one serving size of dishes based on this survey results was suggested for serving in restaurants.
Chickens ; Humans ; Meat ; Restaurants* ; Ribs ; Serving Size*

Toxic epidermal necrolysis (T~EN) is a severe mucocutaneous disease characterized by epidermal necrosis possibly extended to the entire body surface and involving multiple internal organs. Digestive tract may be involved too, but there is few report about gastrointestinal lesion in patient with TEN. Recently we experienced a case of TEN with gastrointestinal bleeding in previously healthy 32-year-old woman. The condition developed three days after the initiation of treatment with NSAID and progressed caudally, involving 60 percent of the skin surfaces. During a period of admission gastrointestinal bleeding was noticed. The gastrofiberscopy showed diffuse superficial mucosal lesion with oozing from swollen friable and erythematous mucosa. The skin lesion was progressed inspite of withdrawal of causative agents. The patient was expired due to combined septic shock 10 days later. We report this case with gastrofiberscopic findings and a brief review of literature.
Adult ; Female ; Gastrointestinal Tract ; Hemorrhage* ; Humans ; Mucous Membrane ; Necrosis ; Shock, Septic ; Skin ; Stevens-Johnson Syndrome*

Although throat culture is a gold standard to diagnose group A streptococcal (GAS) pharyngitis or its sequelae, antistreptolysin O (ASO) is useful to confirm the diagnosis. In case there is no elevation of ASO, it is necessary to add one or more serologic tests, such as antideoxyribonuclease (ADNase) B test. ADNase B levels were analyzed in the carriers of beta-hemolytic streptococci (BHS) in this study. ADNase B concentrations were determined quantitatively by nephelometry (Behring Nephelometer 100 Analyzer, Germany) on 157 sera of healthy elementary school children in Chungnam who were positive of BHS in the throat culture. ASO levels were measured previously by autoanalyzer (Hitachi 747, Japan). Mean ADNase B and ASO levels were compared according to serological group of BHS and number of colonies. The carriers of GAS had significantly higher ADNase B levels (mean 453 IU/ml) than those of non-A beta-hemolytic streptococci (NGAS, 278 IU/ml), while the difference of ASO levels between GAS (482 IU/ml) and NGAS (350 IU/ml) carriers was not so high. The carriers who had more than 10 CFU of BHS had significantly higher ADNase B or ASO levels than those who had less than 10 CFU. The correlation between ADNase B (Y) and ASO (X) was Y=0.4X+229 (r2=0.13). ADNase B test could discriminate GAS from NGAS more effectively than ASO test. The carriers who have more than 10 CFU might undergo asymptomatic infection, as their ADNase B or ASO levels were significantly high. Because distribution of ADNase B showed little correlation to that of ASO, ADNase B test could be used as a supplementary test to diagnose GAS infection.
Antistreptolysin ; Asymptomatic Infections ; Child ; Chungcheongnam-do ; Diagnosis ; Humans ; Nephelometry and Turbidimetry ; Pharyngitis ; Pharynx ; Serologic Tests

BACKGROUND: Anti-OF (opacity factor) antibody (Ab) is useful to study past infection or outbreak of group A streptococci (GAS) and to identify OF antigen (Ag). Throat cultures were taken from 172 elementary school children and venous blood were collected at the same time to screen the frequency of anti-OF Ab. METHODS: The presence of OF Ag was recognized by turbidity of horse serum. OF Ag was identified with inhibition of opacity reaction by known anti-OF Ab. The sera of children were screened for the presence of anti-OF Ab with the representative OF Ag. RESULTS: The positive rate of anti-OF Ab was very high regardless of OF production or throat culture results. Thirty two of 38 (84%) OF Ag producing GAS carriers, 25 of 35 (71%) OF Ag non-producing GAS carriers and 72 of 99 (73%) throat culture negative children harbored anti-OF Ab. While among OF Ag, non-typable and OF 22 were high in prevalence (36.8% and 29.0% respectively), anti-OF 4, anti-OF 28 and anti-OF 12 of OF Ab were identified highly (39.5%, 29.7% and 15.7% respectively). Forty-five (26.2%) among 172 children had two anti-OF Abs and 11 (6.4%) had more than three anti-OF Abs. CONCLUSIONS: Seventy five percent of school children was proven to be previously infected with GAS through this anti-OF Ab study. The anti-OF Ab carrying rates were high, regardless of positivity of throat culture and OF Ag production. We could demonstrate that the prevalent strains of GAS changed in according to time span by proving the difference of frequency of OF Ag and anti-OF Ab and one-fourth of children had been infected with more than 2 different serotypes.
Antibodies* ; Child* ; Horses ; Humans ; Pharynx* ; Prevalence