Background: To evaluate the degree of deformation in patients with ankle osteoarthritis (OA), it is essential to measure the threedimensional (3D), in other words, stereoscopic alignment of the ankle, subtalar, and foot arches. Generally, measurement of radiological parameters use two-dimensional (2D) anteroposterior and lateral radiographs in a weight-bearing state; however, computeraided 3D analysis (Disior) using weight-bearing cone-beam computed tomography (CBCT) has recently been introduced. Methods: In this study, we compared the 2D human radiographic method with a stereoscopic image in patients with ankle arthritis. We enrolled 57 patients diagnosed with OA (28 left and 29 right) and obtained both standing radiographs and weight-bearing CBCT. Patients were divided by the Takakura stage. The interclass correlation coefficient (ICC) for each result was confirmed. Results: On the ICC between 2D radiographs and 3D analysis, the tibiotalar surface angle and lateral talo-1st metatarsal angle showed a good ICC grade (> 0.6), while other parameters did not have significant ICC results. Three-dimension was superior to radiographs in terms of statistical significance. Conclusions We demonstrated that 2D and stereoscopic images are useful for the diagnosis of OA. Our study also confirmed that the radiographic features affected by ankle OA varied. However, according to the results, the typical radiography is not sufficient to diagnose and determine a treatment plan for ankle OA. Therefore, the method of using 3D images should be considered.

No abstract available.
Korea* ; Salmonella*

BACKGROUND: Since 1982, many countries has reported outbreaks or sporadic cases caused by enterohaemorrhagic Escherichia coli (EHEC) serogroup strains, mainly E. coli O157:H7 type strain. However, systemic investigation about EHEC agents, including E. coli O157:H7, have not been done in Korea. Therefore, we investigated serogroup and verotoxin productivity of E. coli strains isolated from diarrheal patients and estimated risk of human infection in comparison with the EHEC strains isolated from cow, pig, and food material in Korea. METHODS: Diarrheal patient stool samples were collected and E. coli strains were isolated, according to biochemical characteristics. In order to isolate E. coli O157:H7, D-Sorbitol negative E. coli strains were selected. Serogrouping of the E. coli isolates was done by agglutination test. Verocytotoxin productivity was investigated by polymerase chain reaction (PCR) and reversed passive latex agglutination (RPLA). Human infection risk was estimated in comparison with EHEC strains isolated from cow, pig and food materials in Korea. RESULTS: Twenty-five E. coli strains were isolated from the diarrheal patients who were suspected to be infected with EHEC. However, none of these E. coli strains produced verocytotoxin. Out of 25 E. coli isolates, 16 serogroups of E. coli O1, O6, O8, O15, O20, O25, O26, O28, O29, O44, O86a, O119, O126, O128, O152 and 157:H- were found. In each of the E. coli O157:H- and O25 serogrorps 3 strains were found. CONCLUSION: None of 25 E. coli isolated from diarrheal patients who were suspected of EHEC infection produced verocytotoxin producing E. coli have been reported recently in Korea.
Agglutination ; Agglutination Tests ; Disease Outbreaks ; Efficiency* ; Enterohemorrhagic Escherichia coli ; Escherichia coli* ; Escherichia* ; Humans ; Korea* ; Latex ; Polymerase Chain Reaction ; Shiga Toxins

BACKGROUND/OBJECTIVES: This study evaluated whether a mobile health (mHealth) application can instigate healthy behavioral changes and improvements in metabolic disorders in individuals with metabolic abnormalities. SUBJECTS/METHODS: Participants were divided into an mHealth intervention group (IG), which used a mobile app for 24 weeks, and a conventional IG. All mobile apps featured activity monitors, with blood pressure and glucose monitors, and body-composition measuring devices. The two groups were compared after 24 weeks in terms of health-behavior practice rate and changes in the proportion of people with health risks, and health behaviors performed by the IG that contributed to reductions in more than one health risk factor were analyzed using multiple logistic regression. RESULTS: Preference for low-sodium diet, reading nutritional facts, having breakfast, and performing moderate physical activity significantly increased in the mHealth IG. Furthermore, the mHealth IG showed a significant increase of eight items in the mini-dietary assessment; particularly, the items “I eat at least two types of vegetables of various colors at every meal” and “I consume dairies, such as milk, yogurt, and cheese, every day.” The proportion of people with health risks, with the exception of fasting glucose, significantly decreased in the mHealth IG, while only the proportion of people with at-risk triglycerides and waist circumference of females significantly decreased in the control group. Finally, compared to those who did not show improvements of health risks, those who showed improvements of health risks in the mHealth IG had an odds ratio of 1.61 for moderate to vigorous physical activity, 1.65 for “I do not add more salt or soy sauce in my food,” and 1.77 for “I remove fat in my meat before eating.” CONCLUSIONS: The findings suggest that the additional use of a community-based mHealth service through a mobile application is effective for improving health behaviors and lowering metabolic risks in Koreans.
Blood Pressure ; Breakfast ; Cheese ; Delivery of Health Care ; Diet ; Diet, Sodium-Restricted ; Disease Management ; Fasting ; Female ; Glucose ; Health Behavior ; Humans ; Logistic Models ; Meat ; Milk ; Mobile Applications ; Motor Activity ; Odds Ratio ; Public Health ; Risk Factors ; Smartphone ; Soy Foods ; Telemedicine ; Triglycerides ; Vegetables ; Waist Circumference ; Yogurt

Craniopharyngiomas are rare primary intracranial tumors. Despite their benign histological appearance, they are often associated with an unfavorable prognosis. The typical manifestations upon diagnosis are headache, visual impairment, polyuria/polydypsia, growth retardation, disturbance of pubertal development, and significant weight gain. The treatment options include radical surgery or radiotherapy, or a combination of these modalities. Slipped capital femoral epiphysis (SCFE) is the most common adolescent hip disorder. SCFE occurs when the capital femoral epiphysis displaces posteriorly on the femoral neck at the level of the physis. The etiology of SCFE is thought to be multifactorial and may include obesity, growth surges, and less common endocrine disorders. The related endocrine disorders include hypothyroidism, growth hormone supplementation, hypogonadism, and panhypopituitarism. Reported herein is a case of panhypopituitarism caused by craniopharyngioma combined with SCFE.
Adolescent ; Craniopharyngioma* ; Diagnosis ; Epiphyses ; Femur Neck ; Growth Hormone ; Headache ; Hip ; Humans ; Hypogonadism ; Hypopituitarism ; Hypothyroidism ; Obesity ; Prognosis ; Radiotherapy ; Slipped Capital Femoral Epiphyses* ; Vision Disorders ; Weight Gain

BACKGROUND: Polymerase-chain reaction (PCR) detection is useful to diagnosis of pertussis at initial stage because the growth rate of Bordetella pertussis (B. pertussis) is relatively slow. Currently, the primer set for the insertion sequence IS481 (BP primer) is used widely for PCR detection of B. pertussis. However, the cross-reactivity of BP primer set with Bordetella holmesii (B. holmesii) was reported recently. Therefore, discrimination of B. pertussis and B. holmesii is needed in PCR step. For this reason, we developed new primer sets based on 16S rDNA sequence for diagnostic use and estimated the efficiency of these new primer sets. MATERIALS AND METHODS: The specific PCR primers were designed from the aligned sequence matrix of 16S rDNA genes of various Bordetella species. The specificity of designed primers were estimated using clinically important 4 Bordetella species, B. pertussis, B. holmesii, Bordetella parapertussis (B. parapertussis) and Bordetella bronchiseptica (B. bronchiseptica). The sensitivity to B. pertussis of designed primers was also estimated and compared with BP primer set. RESULTS: As the results, the developed new primer set successfully distinguished B. pertussis and other Bordetella species containing B. holmesii. In the sensitivity assay, the detectable limits of 16S-F2/16S-R1 primer set for B. pertussis were revealed as 5 pg of genomic DNA and 105 cells/mL of cell suspension. In addition to these, identical results between BP with primer and new primer were obtained in clinical samples. CONCLUSION: In this study, the specific primer set for B. pertussis was developed based on 16S rDNA sequence and this primer set did not show cross-reactivity to B. holmesii. In addition to these, the applicability of this primer set to the clinical specimens was also confirmed.
Bordetella ; Bordetella bronchiseptica ; Bordetella parapertussis ; Bordetella pertussis ; Discrimination (Psychology) ; DNA ; DNA, Ribosomal ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Whooping Cough

BACKGROUND: Polymerase-chain reaction (PCR) detection is useful to diagnosis of pertussis at initial stage because the growth rate of Bordetella pertussis (B. pertussis) is relatively slow. Currently, the primer set for the insertion sequence IS481 (BP primer) is used widely for PCR detection of B. pertussis. However, the cross-reactivity of BP primer set with Bordetella holmesii (B. holmesii) was reported recently. Therefore, discrimination of B. pertussis and B. holmesii is needed in PCR step. For this reason, we developed new primer sets based on 16S rDNA sequence for diagnostic use and estimated the efficiency of these new primer sets. MATERIALS AND METHODS: The specific PCR primers were designed from the aligned sequence matrix of 16S rDNA genes of various Bordetella species. The specificity of designed primers were estimated using clinically important 4 Bordetella species, B. pertussis, B. holmesii, Bordetella parapertussis (B. parapertussis) and Bordetella bronchiseptica (B. bronchiseptica). The sensitivity to B. pertussis of designed primers was also estimated and compared with BP primer set. RESULTS: As the results, the developed new primer set successfully distinguished B. pertussis and other Bordetella species containing B. holmesii. In the sensitivity assay, the detectable limits of 16S-F2/16S-R1 primer set for B. pertussis were revealed as 5 pg of genomic DNA and 105 cells/mL of cell suspension. In addition to these, identical results between BP with primer and new primer were obtained in clinical samples. CONCLUSION: In this study, the specific primer set for B. pertussis was developed based on 16S rDNA sequence and this primer set did not show cross-reactivity to B. holmesii. In addition to these, the applicability of this primer set to the clinical specimens was also confirmed.
Bordetella ; Bordetella bronchiseptica ; Bordetella parapertussis ; Bordetella pertussis ; Discrimination (Psychology) ; DNA ; DNA, Ribosomal ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Whooping Cough

Paragonimiasis is an infectious disease caused by trematodes of the genus Paragonimus. This trematode can be treated successfully with praziquantel in more than 90% of the cases. Although praziquantel is generally well tolerated, anaphylactic reactions to this drug have been reported in a few cases. We report here a 46-year-old Korean female with paragonimiasis, presumed to be due to Paragonimus westermani, who displayed an allergic reaction to praziquantel and resistance to triclabendazole treatment. The patient was successfully treated with praziquantel following a rapid desensitization procedure. Desensitization to praziquantel could be considered when no alternative drugs are available.
Animals ; Benzimidazoles/*therapeutic use ; *Desensitization, Immunologic ; Drug Hypersensitivity/etiology/immunology/*therapy ; *Drug Resistance ; Female ; Humans ; Middle Aged ; Paragonimiasis/*drug therapy/immunology/parasitology ; Paragonimus/isolation & purification/physiology ; Praziquantel/*adverse effects/*immunology/therapeutic use ; Treatment Outcome

Pertussis is a representative vaccine-preventable disease. However, there have been recent outbreaks in countries where even higher vaccination against the disease. One reason is the emergence of antigenic variants, which are different to vaccine type. In Korea, reported cases have rapidly increased since 2009. Therefore, we analyzed genotype of strains isolated in 2011-2012 by multilocus sequence typing method. As expected, the genotype profiles of tested genes dramatically changed. The major sequence type changed from ST1 to ST2, and new sequence type (ST8) appeared. In the minimum spanning tree, recent isolates belonging to the ACC-I-ST3 subgroup were detected that were composed of ST2, ST3, and ST6. In particular, the ST2 frequency increased to 81%. The novel ST8 was linked to the increased frequency of ST2. In addition, toxic strains carrying the ptxP3 promoter type were confirmed. This ptxP3 type emerged from 2009 and its frequency had increased to 100% in 2012. Based on these results, it can be inferred that the genotypic changes in the currently circulating strains are strongly associated with the recent increasing of pertussis in Korea. Therefore, the surveillance system should be strengthened, and genetic characterization of the isolates should be expanded to the whole genome sequence level.
*Antigenic Variation ; Antigens/*genetics/immunology/metabolism ; Bacterial Proteins/genetics/metabolism ; Bordetella pertussis/*genetics/isolation & purification/*metabolism ; Genes, Bacterial ; Genotype ; Humans ; Pertussis Toxin/genetics/metabolism ; Promoter Regions, Genetic ; Republic of Korea ; Sequence Analysis, DNA ; Whooping Cough/immunology/*microbiology/pathology

PURPOSE: Pertussis was very common in the past, but reported cases have dramatically decreased. The improvement of vaccination programs and unreadiness of laboratory confirmation seems to have developed this situation. This study investigated the frequency of pertussis among infants with a paroxysmal cough and compared the clinical characteristics between infants with and without pertussis. METHODS: Between June and November 2006, 27 infants admitted to the hospital that were 15-90 days old with a history of a cough for more than seven days were enrolled. The cough was described as: paroxysmal, whooping, and post-tussive vomiting. PCR and cultures for Bordetella pertussis with nasopharyngeal aspirates were obtained. The patients were divided into two groups: (1) the pertussis group that had positive results by PCR or culture; (2) the control group that had negative results by PCR and culture. Clinical and laboratory characteristics were compared between the two groups. RESULTS: Among the 27 cases, five (18.5%) were finally diagnosed with pertussis. Only one out of the five pertussis cases was initially diagnosed with a pertussis-like syndrome on admission. Compared to the group without pertussis, the pertussis group had a significantly higher frequency of: no fever (P=0.043), a paroxysmal cough (P=0.040), cyanosis (P=0.001), non-immunized status for DTaP (P=0.047), normal auscultation (P=0.028), normal chest X-ray findings (P=0.027), high absolute lymphocyte count (P=0.039), and low CRP (P=0.046). The patients with the diagnosis of pertussis had a significantly longer duration of coughing (27.2+/-10.6 vs. 12.6+/-5.6 days, P=0.039). CONCLUSION: Pertussis should be suspected in any infant with typical symptoms of pertussis in addition to: a persistent cough without fever, accompanied by paroxysms or cyanosis prior to the age of DTaP immunization. Active laboratory confirmation should be carried out to confirm more cases with pertussis.
Auscultation ; Bordetella pertussis ; Cough ; Cyanosis ; Fever ; Humans ; Immunization ; Infant ; Lymphocyte Count ; Polymerase Chain Reaction ; Thorax ; Vaccination ; Vomiting ; Whooping Cough