OBJECTIVES: In September 2008, an outbreak of diarrhea occurred among students attending Y school in Yeongcheon-si. Shigella sonnei was cultured from some of the rectal swabs. An epidemiological investigation was carried out to determine the source of the infection and the mode of transmission of the shigellosis outbreak. METHODS: The index case lived in the D rehabilitation facility in Gyeongsan-si and an additional epidemiological investigation was carried out there. The cases could not be questioned due to their mental handicaps. The teachers were interviewed instead. A patient case was defined as a resident with diarrhea more than one time a day from September 18 to September 26, 2008 or a resident with confirmed Shigella sonnei at the Y school or the D rehabilitation facility. RESULTS: The attack rate was 1.2% (8 persons) among 659 persons in the Y school and D rehabilitation facility. Five persons were microbiologically confirmed to have the infection and three persons were diagnosed on the basis of symptoms. Shigella sonnei was cultured from five of the 659 rectal swabs. However, 80 environmental specimens including drinking water, preserved foods, and cooking utensils were negative. All eight patients were Y school students and had been living in group boarding and lodging. Six of them lived in the D rehabilitation facility and two lived in the dormitory at the Y school. Five cases showed pulsed-field gel electrophoresis patterns that were identical for Shigella sonnei. CONCLUSIONS: The results of this study showed that the infection source of the shigellosis outbreak, in the two places, were identical. It is likely that the infections initially spread from a teacher or volunteer and then among the students.
Cooking and Eating Utensils ; Diarrhea ; Disabled Persons ; Disease Outbreaks ; Drinking Water ; Dysentery, Bacillary ; Electrophoresis, Gel, Pulsed-Field ; Food, Preserved ; Humans ; Intellectual Disability ; Korea ; Shigella ; Shigella sonnei

PURPOSE: Hyperhomocysteinemia was observed in epileptic patients receiving anticonvulsants, especially homozygotes for mtehylenetetrahydrofolate reductase (MTHFR) gene 677C->T mutation. Hyperhomocysteinemia induce atherosclerosis, fetal anticonvulsant syndrome, etc. Therefore, we examined any other factors that might affect the level of homocysteine in epileptic patients. METHODS: We investigated the plasma total homocysteine level in 145 patients with epilepsy. And then we analyzed various factors (clinical findings, neuro-image finding, drugs, MTHFR gene, serum folate and vitamin B12 level) affecting the level of homocysteine. RESULTS: Among the various factors, male, present neurological deficits, frequent seizure attacks, MTHFR gene 677 TT genotype, polypharmacy, and conventional drug (phenytoin, carbamazepine, valproic acid, phenobarbital, primidone, benzodiazpines) than new drug (lamotrigine, vigabatrin, topiramate, oxcarbazepine zonisamide) were related with elevated homocysteine levels. CONCLUSION: We recommend monotherapy with new drugs and higher vitamin requirement in the male epileptic patients of MTHFR TT genotype with neurological deficits and frequent seizure attacks.
Anticonvulsants ; Atherosclerosis ; Carbamazepine ; Epilepsy ; Folic Acid ; Genotype ; Homocysteine* ; Homozygote ; Humans ; Hyperhomocysteinemia ; Male ; Oxidoreductases ; Phenobarbital ; Plasma ; Polypharmacy ; Primidone ; Seizures ; Valproic Acid ; Vigabatrin ; Vitamin B 12 ; Vitamins

The osteoarthritis is being emphasized in South Korea becoming an aged society. It is desirable to use a model that reflects human disease when using an animal model to understand the pathophysiology of osteoarthritis and verify the effective treatment materials. Because naturally occuring osteoarthritis is rare in rodent models, chemical or surgical methods are used to induce diseases. While these methods have the advantages of consistent occurrence and rapid progress of osteoarthritis, it is controversial about whether experimentally-induced osteoarthritis progresses in the same pathophysiology of human disease. The model using injection of chemical materials such as collagenase or monoiodoaceatate in joint space has been widely used. Each method leads to joint damage by chemical joint instability with destruction of articular connective tissue and cartilage cell apoptosis with inhibition of cell metabolism. Anterior cruciate ligament resection model, meniscus resection model, collateral ligament resection model, menisco-tibia ligament resection model and etc. are used as surgical models. These days, it tends to be used menisco-tibia ligament resection model more. It is required to observe the joint damage as well as induction of pain, recently. This review considers how to induce osteoarthritis of knee model used widely, usage of the pathogenesis studies, advantages and disadvantages.
Animals* ; Anterior Cruciate Ligament ; Apoptosis ; Cartilage ; Cartilage, Articular ; Collagenases ; Collateral Ligaments ; Connective Tissue ; Humans ; Joint Instability ; Joints ; Korea ; Ligaments ; Metabolism ; Models, Anatomic ; Models, Animal* ; Models, Chemical ; Osteoarthritis* ; Osteoarthritis, Knee ; Rodentia

OBJECTIVES: Cord blood stem cells have been widely used as donor cells for bone marrow transplantation recently. These cells can give rise to a variety of hematopoietic lineages to repopulate the blood. Recent observations reveal that some bone marrow cells and bone marrow stromal cells(MSCs) can grow to become either neurons or glial cells. It is, however, unclear whether or not there exists stems cells which can differentiate into neurons in the blood during the early stages of postnatal life. METHODS: Human cord blood stem cells were prepared from human placenta after full term delivery. To induce neuronal differentiation of stem cells, beta-mercaptoethanol was treated. To confirm the neuro-glial characteristics of differentiated stem cells, immunocytochemical stain for NeuN, neurofilament, glial fibrillary acidic protein(GFAP), microtubule associated protein2(MAP2) was performed. RT-PCR was performed for detecting nestin mRNA and MAP2 mRNA. RESULTS: We showed in this experiment that neuro-glial markers(NeuN, neurofilament, MAP2, GFAP) were expressed and axon-like cytoplasmic processes are elaborated in the cultured human cord blood stem cells prepared from new born placenta after full term delivery. Nestin mRNA was also detected in fresh cord blood monocytes. Conclusions: These results suggest that human cord blood derived stem cells may be potential sources of neurons in early postnatal life.
Bone Marrow ; Bone Marrow Cells ; Bone Marrow Transplantation ; Cytoplasm ; Fetal Blood* ; Humans* ; Microtubules ; Monocytes ; Nestin ; Neural Stem Cells ; Neuroglia ; Neurons ; Placenta ; RNA, Messenger ; Stem Cells ; Tissue Donors ; Umbilical Cord*

No abstract available.
Paragonimiasis*

A novel glucanhydrolase from a mutant of Lipomyces starkeyi KSM 22 has additional amylase activity besides mutanolytic activity and has been suggested as promising anti-plaque agent. It has been shown effective in hydrolysis of mutan, reduction of mutan formation by Streptococcus mutans and removal pre-formed sucrosedependent adherent microbial film and has been strongly bound to hydroxyapatitie. These in vitro properties of Lipomyces starkeyi KSM 22 glucanhydrolase are desirable for its application as a dental plaque control agent. In human experimental gingivitis model and 6 month clinical trial, mouthrinsing with Lipomyces starkeyi KSM 22 dextranase was comparable to 0.12% chlorhexidine mouthwash in inhibition of plaque accumulation and gingival inflammation and local side effect was negligible. This study was aimed to evaluate the cytotoxic effect of Lipomyces starkeyi KSM 22 glucanhydrolase on human gingival fibroblasts. Primary culture of human gingival fibroblasts at the 4th to 6th passages were used. Glucanhydrolase solution was made from lyophilized glucanhydrolase powder from a mutant of Lipomyces starkeyi KSM 22 solved in PBS and added to DMEM medium to the final concentration of 0.5, 1, and 2 unit. Cells were exposed to glucanhydrolase solution or 0.1 % chlorhexidine and the cells cultured in DMEM with 10% FBS and 1% antibiotics as control. After exposure, the morphological change, cell attachment, and cell activity by MTT assay were evaluated in 0.5, 1.5, 3, 6, 24 hours after treatment. The cell proliferation and cell activity was also evaluated at 2 and 7 days after 1 minute exposure, twice a day. The cell morphology was similar between the Lipomyces starkeyi KSM 22 glucanhydrolase groups and control group during the incubation periods, while most fibroblasts remained as round cell regardless of incubation time in the chlorhexidine group. The numbers of the attached cells in the glucanhydrolase groups were comparable to that of control and significantly higher than the chlorhexidine group. The numbers of the proliferated cells in the glucanhydrolase groups at 7 days of incubation were comparable to the control group and higher than the chlorhexidine group. The cell activity in glucanhydrolase groups paralleled with the increased cell number by attachment and proliferation. According to these results, Lipomyces starkeyi KSM 22 glucanhydrolase has little harmful effect on attach-ment and proliferation of human gingival fibroblasts, in contrast to 0.1% chlorhexidine which was cytotoxic to human gingival fibroblasts. Therefore this glucanhydrolase preparation is considered as a safe and promising agent for new mouthwash formula in the near future.
Amylases ; Anti-Bacterial Agents ; Cell Count ; Cell Proliferation ; Chlorhexidine ; Dental Plaque ; Dextranase ; Fibroblasts* ; Gingivitis ; Humans* ; Hydrolysis ; Inflammation ; Lipomyces* ; Streptococcus mutans

PURPOSE: In May 2008, a diarrhea outbreak occurred among students of in a girls' high school (S school) in Sangju-si, Korea. An epidemiological investigation was carried out to clarify the cause and transmission route of the outbreak. METHODS: S school has been providing meals directly since July 2007. We conducted a questionnaire survey among 591 persons, and examined 283 rectal swabs and 98 environmental specimens. The patient case was defined as a member of S school who had diarrhea more than one time in a day, accompanied with one or more symptoms among abdominal pain or tenesmus from May 19th to May 26th 2008. RESULTS: The attack rate was 24.0%. Bacillus cereus were cultured from three of the rectal swabs and five of the preserved foods. It was suspicious that contamination was possible in seasoning vegetables, and we found some foods were seasoned with spices after being cooled by moving cooler for about 20 minutes. Enterotoxin positive B. cereus were cultured from two foods cooled by moving cooler. Enterotoxin negative B. cereus were cultured from two environmental specimens of the moving cooler. CONCLUSIONS: We presumed the cause of the diarrhea outbreak in S school was food poisoning by B. cereus. Because enterotoxin positive B. cereus were cultured from rectal swabs and foods, and the symptoms were corresponded. We estimated the outbreak was occurred by this process that B. cereus in the moving cooler contaminated foods during cooling and then rapidly proliferated.
Abdominal Pain ; Bacillus ; Bacillus cereus ; Diarrhea ; Disease Outbreaks ; Enterotoxins ; Food, Preserved ; Foodborne Diseases ; Humans ; Korea ; Meals ; Seasons ; Spices ; Vegetables ; Surveys and Questionnaires

Lichen nitidus (LN) is an uncommon chronic inflammatory skin disease composed of numerous, tiny, shiny, flesh-colored papules that are predominantly observed on the chest, abdomen, glans penis and upper extremities. The distribution of LN is most often localized, but in some cases it can become generalized. Because LN tends to be asymptomatic and presents spontaneous resolution within several years, it usually does not require treatment except in symptomatic, persistent and generalized cases. We describe a 28-yr-old man and a 7-yr-old boy with generalized LN where both cases improved with narrow-band ultraviolet B (NB-UVB) phototherapy plus topical steroid ointment. Both patients noted improvement within the first three treatments and showed almost complete resolution after 18 and 20 treatments, respectively. NB-UVB phototherapy may be an effective alternative therapy for the treatment of generalized LN, even for those patients in their childhood.
*Ultraviolet Therapy ; PUVA Therapy ; Male ; Lichen Nitidus/pathology/*radiotherapy ; Humans ; Child ; Adult

PURPOSE: Many patients who may be treated in primary care clinics resort to emergency centers during the off hours of such clinics. This may cause overcrowding of emergency centers and increased medical expenses. The aim of this study is to consider the optimal management of medical facilities for pediatric patients at night or on holidays. METHODS: The medical records of patients under the age of 16 years who had visited a pediatric emergency medical center during a two-year period between January 2012 and December 2013 were reviewed retrospectively. We examined how factors including the age group, disease/injury distinction, tentative diagnosis, use of the emergency medical service ambulances, and the final disposition of the patients varied depending on the availability of medical facilities. RESULTS: Among the 32,951 pediatric patients, approximately half visited the center on holidays (51.6%), and a quarter were injury patients (26.4%). Fever (38.8%) and head injury (16.1%) were the most frequent tentative diagnosis in diseases and injuries, respectively. More visits of infants and toddlers and disease patients occurred on days and hours of low medical service availability, and there were relatively few injury patients in the late night hours. CONCLUSION: These findings suggest that closing pediatric clinics around midnight is reasonable. More facilities operating at night and on holidays for pediatric patients are needed.
Ambulances ; Craniocerebral Trauma ; Diagnosis ; Emergencies* ; Emergency Medical Services ; Epidemiology ; Fever ; Health Resorts ; Holidays ; Humans ; Infant ; Medical Records ; Pediatrics ; Primary Health Care ; Retrospective Studies

BACKGROUND: The Spectra Optia (SPO) is a novel continuous-flow centrifugal apheresis system based on the COBE Spectra (CSP) platform. There have been few attempts to validate the advantages of the SPO. We performed a retrospective study comparing the two cell separators for therapeutic plasma exchange (TPE) procedures in kidney transplant (KT) patients and seeing efficacy and safety. METHODS: We analyzed 720 TPE procedures performed between August 2012 and July 2014. Procedures included desensitization TPE before KT and TPE for the management of acute and chronic antibody-mediated graft rejection. Demographic characteristics, operational TPE variables, and laboratory data were analyzed. RESULTS: Demographic characteristics for the SPO (n=389) and CSP (n=331) groups did not differ significantly. The procedure time to exchange one plasma volume was 94.2+/-10.3 min in the SPO group and 100.4+/-11.2 min in the CSP group (P<0.001). The plasma removal efficiency (PRE) was 92.5+/-4.9% in the SPO group and 83.2+/-3.7% in the CSP group (P<0.001). There were no significant differences across the two apheresis systems for changes in hematologic parameters. CONCLUSIONS: Compared with the CSP, the SPO was associated with an improved PRE and a shorter procedure time to exchange one plasma volume. Our results in KT patients show that the SPO is superior to the CSP in TPE procedures.
Blood Component Removal ; Graft Rejection ; Humans ; Kidney ; Kidney Transplantation ; Plasma ; Plasma Exchange* ; Plasma Volume ; Retrospective Studies