In the last years, according to the increasing incidence of measles and other viral diseases, it have been needed to study on not only the fundamental epidemiological characteristics of mumps and measles but also judgement on the effectiveness of vaccine that meet our domestic situation. The author carried out questionnaire to obtain epidemiological characteristics and vaccine efficacy of mumps on epidemics of mumps in one primary school in Hwasung-kun, Kyonggi Do from Feb. to July, 1994. The results are summarized as follows: 1. Total students was 556, but 446(78.4%) responded to the questionnaire. Among that 446,130(29. 1%) have suffered from mumps. From 9 to 10 year old students had the high attack rates, especially 10 year olds has the highest(39. 7%). 2. From Feb. 2, 1994, first case was on, to July 6, 1994, the epidemic was continues, and attack rate was higest in May(50. 5%). 3. Among the 130 mumps patients, 5 have suffered from complication(3.8%) : encephalitis 3(2 in male, 1 in female). 4. Vaccination rate was 91%, and as ages were lowered, the rates were higher. 5. Attack rate was higher in group who had time interval after vaccination less than 5 years than total attack rate, and was higher in group who had been vaccined after 5 year old. 6. Attack rate in vaccinated group was 27.3%. 7. Vaccine efficacies, be judged by three methods of analysis according to case definition and vaccination status, were 37.4 39. 2%. 8. Factors that have significantly affected the mumps epidemic were vaccination status and vaccination age.
Child ; Child, Preschool ; Encephalitis ; Epidemiologic Studies* ; Gyeonggi-do* ; Humans ; Incidence ; Male ; Measles ; Mumps* ; Vaccination ; Virus Diseases ; Surveys and Questionnaires

OBJECTIVES: To estimate mumps incidence during the study period and to evaluate the completeness of case reporting. METHODS: Capture-recapture methods, originally developed for counting wildlife animals, were used. The data sources were 1) the National Notifiable Communicable Disease Reporting System (NNCDRS; 848 cases), 2) the School Health Reporting System, temporarily administered by the Division of Education (SHRS; 1,026 cases), and 3) a survey of students (785 cases). We estimated the number of unobserved mumps cases by matching the three data sources and fitting loglinear models to the data. We then determined the estimated total number of mumps cases by adding this to the number of observed cases. Completeness was defined as the proportion of observed cases from each source to the total of estimated cases. RESULTS: The total number of observed cases was 1,844 and the total number of estimated cases was 1,935 (95% CI: 1,878-2,070). The overall completeness was 43.8% of the NNCDRS, 53.0% of the SHRS, and 40.6% of the survey. However, completeness varied by area and age. CONCLUSION: Although the completeness of NNCDRS data appeared higher than in the past, it is difficult to generalize this result. In Korea, it is possible to estimate the size of health hazards relatively cheaply and quickly, by applying capture-recapture methods to various data using a multiple data collection system.
Animals ; Communicable Diseases ; Information Storage and Retrieval ; Education ; Humans ; Incidence ; Jeju-do* ; Korea ; Mumps* ; School Health Services

Recently, emerging waterborne protozoa, such as microsporidia, Cyclospora, and Cryptosporidium, have become a challenge to human health worldwide. Rapid, simple, and economical detection methods for these major waterborne protozoa in environmental and clinical samples are necessary to control infection and improve public health. In the present study, we developed a multiplex PCR test that is able to detect all these 3 major waterborne protozoa at the same time. Detection limits of the multiplex PCR method ranged from 101 to 102 oocysts or spores. The primers for microsporidia or Cryptosporidium used in this study can detect both Enterocytozoon bieneusi and Encephalitozoon intestinalis, or both Cryptosporidium hominis and Cryptosporidium parvum, respectively. Restriction enzyme digestion of PCR products with BsaBI or BsiEI makes it possible to distinguish the 2 species of microsporidia or Cryptosporidium, respectively. This simple, rapid, and cost-effective multiplex PCR method will be useful for detecting outbreaks or sporadic cases of waterborne protozoa infections.
Cryptosporidium/*isolation & purification ; Cyclospora/*isolation & purification ; DNA Primers/genetics ; DNA Restriction Enzymes/metabolism ; DNA, Protozoan/genetics/metabolism ; Humans ; Microsporidia/*isolation & purification ; Parasitology/*methods ; Polymerase Chain Reaction/*methods ; Polymorphism, Restriction Fragment Length ; Sensitivity and Specificity ; Water/*parasitology

Uremic patients undergoing hemodialysis (HD) therapy are prone to develop encephalopathy, but the cause is often unclear. Clinical signs of encephalopathy in the uremic patient often overlap with several other affections causing neurological disorders. Chorea or hemichorea occurs very rare, when basal ganglia are injured in HD patients. We hereby report a case of hemichorea of unknown cause in a hemodialysis patients. A 57-year-old diabetic HD patient was presented with sudden onset of right hemichorea. We could not find causes of hemichorea such as hyperglycemia, hepatic failure, drug, hyponatremia, and thiamine deficiency. T1-weighted MRI demonstrated hyperintense lesion limited to the left basal ganglion. Hemichorea disappeared completely 6 months after the onset with support care.

Congenital nephrogenic diabetes insipidus (NDI) is a rare disorder of the kidney characterized by the in ability to concentrate urine despite normal or elevated plasma concentration of the antidiuretic hormone agent vasopressin (AVP). We describe a case of congenital nephrogenic diabetes insipidus presenting with mild fever . The 3-day-old baby boy was admitted with mild fever. He has 6 members with DI in his family and his laboratoty finding showed hypernatremia, increased serum osmolarity and low level of urine specific gravity. Throughout the water deprivation test and the vasopressin test, he has been diagnosed as congenital NDI. Urinary free water loss was improved after treatment with hydrochlorothiazide and low salt formula. At the age 4 months, the infant has demonstrated normal growth and neurodevelopmental milestones. An early diagnosis of congenital NDI is very important, since the proper adequate management can prevent hyperosmolarity which might induce the delayed mental and physical development.
Diabetes Insipidus, Nephrogenic* ; Early Diagnosis ; Fever* ; Humans ; Hydrochlorothiazide ; Hypernatremia ; Infant ; Kidney ; Male ; Osmolar Concentration ; Plasma ; Specific Gravity ; Vasopressins ; Water Deprivation

Idiopathic nodular glomerulosclerosis is an unusual entity with histopathologic features resembling nodular diabetic glomerulosclerosis but occurs in non diabetic patients and predominantly in older males with smoking and long standing hypertension. It is characterized histologically by nodular mesangial sclerosis, glomerular basement membrane thickening, and arteriolosclerosis in the absence of immune-type deposit, and clinical presentations typically include renal insufficiency and severe proteinuria with relatively poor prognosis. We experienced a rare case of idiopathic nodular glomerulosclerosis presenting rapid progressive renal failure in a 42-year-old man without clinical evidence of diabetes. He was admitted with peripheral edema and renal insufficiency. He had a history of hypertension for 2 years and chronic hepatitis B for 5 years. Funduscopy and renal ultrasound were normal. HbA1c and oral glucose tolerance test were normal and on serum and urine electrophoresis, M-spike was not found. Light microscopic examination demonstrated the characteristic features of lobular glomerulonephritis showing glomerular hypertrophy and nodular mesangial sclerosis. Immunofluorescence was negative for immune-type deposits. Electron microscopy showed marked increase of mesangial matrix, mesangial cell proliferation, moderate effacement of foot processes, and glomerular basement thickening without electron-dense deposits or other specific fibrils. Idiopathic nodular glomerulosclerosis was diagnosed. After discharge, he continued smoking and his blood pressure was not controlled. Three months after first biopsy, second biopsy was performed because of increasement of serum creatinine and specimens showed progression of tubulointerstitial change and nodular mesangial sclerosis. Subsequent serum creatinine was progressively increased and hemodialysis was started 13 months after diagnosis.
Adult ; Arteriolosclerosis ; Biopsy ; Blood Pressure ; Creatinine ; Diabetic Nephropathies* ; Diagnosis ; Edema ; Electrophoresis ; Fluorescent Antibody Technique ; Foot ; Glomerular Basement Membrane ; Glomerulonephritis ; Glucose Tolerance Test ; Hepatitis B, Chronic ; Humans ; Hypertension ; Hypertrophy ; Male ; Mesangial Cells ; Microscopy, Electron ; Prognosis ; Proteinuria ; Renal Dialysis ; Renal Insufficiency* ; Sclerosis ; Smoke ; Smoking ; Ultrasonography

Fibrosing mediastinitis is a rare benign disorder caused by excessive proliferation of fibrous tissue within the mediastinum. Pulmonary artery stenosis is uncommon complication of fibrosing mediastinitis. We present a case of percutaneous stent deployment in a patient with severe pulmonary artery stenosis causing pulmonary hypertension secondary to fibrosing mediastinitis.
Constriction, Pathologic ; Humans ; Hypertension, Pulmonary* ; Mediastinitis* ; Mediastinum ; Pulmonary Artery* ; Stents*

BACKGROUND: Even though it has been suggested that low-colony, scotochromogen nontuberculous mycobacteria (NTM) are usually contaminants and not true pathogens, evidence for this hypothesis has not been provided. This study investigated the colony characteristics, organism identification, and clinical significance of low-colony scotochromogen. METHODS: The laboratory cultured 6,898 respiratory clinical specimens for an examination of mycobacteria over a three-month period. A low-colony count was arbitrarily defined as < or = 20 colonies. This study analyzed the recovery rate of the mycobacteria, the number of colonies and their gross characteristics, and their clinical significance. PCR- restriction fragment length polymorphism analysis was carried out to identify the NTM species. NTM pulmonary disease was defined according to the American Thoracic Society. RESULTS: A total of 6,898 respiratory specimens for mycobacterium were cultured. Of these, 263 (3.8%) grew NTM, and 382 (5.5%) grew M. tuberculosis. Of the 263 cultured NTM specimens, 124 (47.1%) were scotochromogens. The smear-positive rate was significantly lower in these scotochromogens (4.8%) than in the non-scotochromogens (23.7%) (p<0.05). The most common isolates were M. gordonae (83/102, 81.4%) in the scotochromogens, and MAC (52/121, 43.0%) in the non-scotochromogens. Even though three out of 113 patients with a low-colony scotochromogen has been diagnosed with NTM pulmonary disease, the isolated scotochromogen was not considered to be the cause of the NTM disease but was just a contaminant. CONCLUSION: In this study, the most common isolate of a low-colony count scotochromogen was M. gordonae, which appeared to be contaminants and not true pathogens. Greater efforts in the quality control of a mycobacterium laboratory are needed in cases where there is a high recovery rate of low-colony count scotochromogen.
Gordonia Bacterium ; Humans ; Lung Diseases ; Mycobacterium ; Nontuberculous Mycobacteria* ; Polymorphism, Restriction Fragment Length ; Quality Control ; Tuberculosis

Background: Symptom burden is an important factor in determining the treatment of atrial fibrillation (AF). AF is frequently accompanied by heart failure (HF). This study investigated the characteristics of AF symptoms with concomitant HF. Methods: A total of 4885 patients with AF were consecutively enrolled through a prospective observational registry (the Comparison Study of Drugs for Symptom Control and Complication Prevention of Atrial Fibrillation [CODE-AF] registry). Clinically diagnosed HF was divided into three categories (preserved, mid-range, and reduced ejection fraction [EF]). Symptom severity was assessed using the European Heart Rhythm Association (EHRA) classification. Results: The presence of AF-related symptoms was comparable irrespective of concomitant HF. Patients with HF with reduced EF demonstrated severe (EHRA classes 3 and 4) and atypical symptoms. HF with preserved EF was also associated with atypical symptoms. Female sex and AF type were associated with the presence of symptoms in AF without HF, and non-maintenance of sinus rhythm and increased left atrial pressure (E/e′ ≥ 15) were factors related to the presence of symptoms in AF with HF. Conclusion AF with concomitant HF presented with more severe and atypical symptoms than AF without HF. Maintaining the sinus rhythm and reducing the E/e’ ratio are important factors for reducing symptoms in AF with concomitant HF.

BACKGROUND: From May to July 2015, the Republic of Korea experienced the largest outbreak of Middle East respiratory syndrome (MERS) outside the Arabian Peninsula. A total of 186 patients, including 36 deaths, had been diagnosed with MERS-coronavirus (MERS-CoV) infection as of September 30th, 2015. MATERIALS AND METHODS: We obtained information of patients who were confirmed to have MERS-CoV infection. MERS-CoV infection was diagnosed using real-time reverse-transcriptase polymerase chain reaction assay. RESULTS: The median age of the patients was 55 years (range, 16 to 86). A total of 55.4% of the patients had one or more coexisting medical conditions. The most common symptom was fever (95.2%). At admission, leukopenia (42.6%), thrombocytopenia (46.6%), and elevation of aspartate aminotransferase (42.7%) were observed. Pneumonia was detected in 68.3% of patients at admission and developed in 80.8% during the disease course. Antiviral agents were used for 74.7% of patients. Mechanical ventilation, extracorporeal membrane oxygenation, and convalescent serum were employed for 24.5%, 7.1%, and 3.8% of patients, respectively. Older age, presence of coexisting medical conditions including diabetes or chronic lung disease, presence of dyspnea, hypotension, and leukocytosis at admission, and the use of mechanical ventilation were revealed to be independent predictors of death. CONCLUSION: The clinical features of MERS-CoV infection in the Republic of Korea were similar to those of previous outbreaks in the Middle East. However, the overall mortality rate (20.4%) was lower than that in previous reports. Enhanced surveillance and active management of patients during the outbreak may have resulted in improved outcomes.
Antiviral Agents ; Aspartate Aminotransferases ; Coronavirus Infections* ; Disease Outbreaks ; Dyspnea ; Extracorporeal Membrane Oxygenation ; Fever ; Humans ; Hypotension ; Leukocytosis ; Leukopenia ; Lung Diseases ; Middle East Respiratory Syndrome Coronavirus ; Middle East* ; Mortality ; Pneumonia ; Polymerase Chain Reaction ; Republic of Korea* ; Respiration, Artificial ; Thrombocytopenia