Hansen's disease (leprosy) is a chronic infectious disease caused by Mycobacterium leprae which affect mainly skin and nerve systems. Currently the incidence of leprosy reached the goals set by WHO in the year 2000. In recent 10 years, only 47 new patients were found in Koreans and their average age was over 70. A 21 year-old young man showed multiple erythematous papules, macules and plaque at face, extremities and trunk. In family history, his grandfather was diagnosed with leprosy at young age and leprosy was recurred when the patient was 7 years old. The patient lived with grandfather from birth to 7 years old. Clinico-pathologically he was diagnosed with a lepromatous leprosy. We performed VNTR both at the skin tissue of grandfather and patient to find out the infection pathway of the patient and found some consistent. Herein, we report a new case of young Korean male transmitted from grandfather.
Communicable Diseases ; Extremities ; Grandparents ; Humans ; Incidence ; Leprosy* ; Leprosy, Lepromatous ; Male ; Minisatellite Repeats ; Mycobacterium leprae ; Parturition ; Skin

BACKGROUND: Leprosy is a contagious chronic granulomatous disease and is a disease that is associated with defects in cellular immunity. A high prevalence of hepatitis C virus infection in leprosy patients has been reported in several African countries, Yemen, Brazil and Japan. In Korea, it's seropositivity was reported as 8.33%(2001), 39.3%(2002), 35.1%(2009) and 16.0%(2009) on Korean Leprosy Bulletin. OBJECTIVE: In the meantime, the studies were limited to the subjects in a specific region, and the number of subjects was not enough, so it was not enough to evaluate the hepatitis C virus seropositivity of persons affected by leprosy in Korea. So this study was conducted to evaluate the it's seropositivity in settlement villages nationwide. METHOD: This study was conducted that the mobile team visited the resettlement villages nationwide from 2009 to 2017 and conducted on persons affected by leprosy and residents residing in resettlement village. Obtained serums were assayed by the ADVIA Centaur HVC(IgG antibodies to Hepatitis C Virus) reagent using a Siemens ADVIA Centaur CP instrument. The results of persons affected by leprosy and residents were compared, and the difference of seropositivity among the groups(male and female, multibacillary and paucibacillary, locations of resettlement villages) was evaluated. RESULT: The results of hepatitis C virus antibody positivity of 1669 persons affected by leprosy subjects and 185 residents of resettlement villages were 28.46% in persons affected by leprosy and 6.49% in residents(Pearson's Chi-Square test, P = 0.00). In persons affected by leprosy, that were 31.99%(male) and 26.84%(female)(Pearson's Chi-Square test, P = 0.06) and were 29.97%(multibacillary) and 25.36%(paucibacillary)(Pearson's Chi-Square test, P = 0.05). That of Seoul(48.28%), Busan(43.78%) and Chungbuk Province(35.94%) were highly positive and that of Gangwon Province(20.34%) was lowly positive(Fisher's Exact test P = 0.002). CONCLUSION: In this study, we found that hepatitis C virus antibody positivity rate was high in persons affected by leprosy in Korea. In order to explain the high positive rate, further studies will be needed. Also, through various approaches including assessment of HCV RNA to the subjects who were judged to be positive for antibody test in the future, a comprehensive evaluation of hepatitis C and its countermeasures are needed.
Antibodies ; Brazil ; Chungcheongbuk-do ; Female ; Gangwon-do ; Granulomatous Disease, Chronic ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Immunity, Cellular ; Japan ; Korea* ; Leprosy* ; Methods ; Prevalence ; RNA ; Yemen

The relationship between anti-Plasmodium vivax circumsporozoite protein (CSP) antibody levels and the prevalence of malaria in epidemic areas of South Korea was evaluated. Blood samples were collected from inhabitants of Gimpo-si (city), Paju-si, and Yeoncheon-gun (county) in Gyeonggi-do (province), as well as Cheorwon-gun in Gangwon-do from November to December 2004. Microscopic examinations were used to identify malaria parasites. ELISA was used to quantitate anti-circumsporozoite protein (CSP) antibodies against P. vivax. A total of 1,774 blood samples were collected. The overall CSP-ELISA-positive rate was 7.7% (n=139). The annual parasite incidences (APIs) in these areas gradually decreased from 2004 to 2005 (1.09 and 0.80, respectively). The positive rate in Gimpo (10.4%, 44/425) was the highest identified by CSP-ELISA. The highest API was found in Yeoncheon, followed by Cheorwon, Paju, and Gimpo in both years. The positive rates of CSP-ELISA were closely related to the APIs in the study areas. These results suggest that seroepidemiological studies based on CSP may be helpful in estimating the malaria prevalence in certain areas. In addition, this assay can be used to establish and evaluate malaria control and eradication programs in affected areas.
Adolescent ; Adult ; Antibodies, Protozoan/*blood ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Incidence ; Malaria, Vivax/*blood/*epidemiology/parasitology ; Male ; Middle Aged ; Plasmodium vivax/*immunology/physiology ; Prevalence ; Protozoan Proteins/immunology ; Republic of Korea/epidemiology ; Seroepidemiologic Studies ; Young Adult

BACKGROUND/AIMS: Treating hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) remains controversial. We compared the outcomes of hepatic resection (HR), transarterial chemoembolization (TACE), and sorafenib therapy as treatments for HCC with PVTT. METHODS: Patients diagnosed as HCC with PVTT between January 2000 and December 2011 who received treatment with sorafenib, HR, or TACE were included. Patients with main PVTT, superior mesenteric vein tumor thrombosis, or Child-Turcotte-Pugh (CTP) class C were excluded. The records of 172 patients were analyzed retrospectively. HR, TACE, and sorafenib treatment were performed is 40, 80, and 52 patients respectively. PVTT was classified as either involving the segmental branch (type I) or extending to involve the right or left portal vein (type II). RESULTS: The median survival time was significantly longer in the HR group (19.9 months) than in the TACE and sorafenib groups (6.6 and 6.2 months, respectively; both p<0.001), and did not differ significantly between the latter two groups (p=0.698). Among patients with CTP class A, type I PVTT or unilobar-involved HCC, the median survival time was longer in the HR group than in the TACE and sorafenib groups (p=0.006). In univariate analyses, the initial treatment method, tumor size, PVTT type, involved lobe, CTP class, and presence of cirrhosis or ascites were correlated with overall survival. The significant prognostic factors for overall survival in Cox proportional-hazards regression analysis were initial treatment method (HR vs. TACE: hazard ratio=1.750, p=0.036; HR vs. sorafenib: hazard ratio=2.262, p=0.006), involved lobe (hazard ratio=1.705, p=0.008), PVTT type (hazard ratio=1.617, p=0.013), and CTP class (hazard ratio=1.712, p=0.012). CONCLUSIONS: Compared with TACE or sorafenib, HR may prolong the survival of patients with HCC in cases of CTP class A, type I PVTT or unilobar-involved HCC.
Adult ; Aged ; Antineoplastic Agents/*therapeutic use ; Carcinoma, Hepatocellular/complications/drug therapy/*therapy ; Chemoembolization, Therapeutic ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms/complications/drug therapy/*therapy ; Male ; Middle Aged ; Niacinamide/*analogs & derivatives/therapeutic use ; Phenylurea Compounds/*therapeutic use ; Portal Vein ; Proportional Hazards Models ; Retrospective Studies ; Severity of Illness Index ; Survival Rate ; Treatment Outcome ; Venous Thrombosis/*complications

Plasmodium vivax reemerged in the Republic of Korea (ROK) in 1993, and is likely to continue to affect public health. The purpose of this study was to measure levels of anti-P. vivax antibodies using indirect fluorescent antibody test (IFAT) in border areas of ROK, to determine the seroprevalence of malaria (2003-2005) and to plan effective control strategies. Blood samples of the inhabitants in Gimpo-si, Paju-si, and Yeoncheon-gun (Gyeonggi-do), and Cheorwon-gun (Gangwon-do) were collected and kept in Korea Centers for Disease Control and Prevention (KCDC). Out of a total of 1,774 serum samples tested, the overall seropositivity was 0.94% (n=17). The seropositivity was the highest in Paju-si (1.9%, 7/372), followed by Gimpo-si (1.4%, 6/425), Yeoncheon-gun (0.67%, 3/451), and Cheorwon-gun (0.19%, 1/526). The annual parasite incidence (API) in these areas gradually decreased from 2003 to 2005 (1.69, 1.09, and 0.80 in 2003, 2004, and 2005, respectively). The highest API was found in Yeoncheon-gun, followed by Cheorwon-gun, Paju-si, and Gimpo-si. The API ranking in these areas did not change over the 3 years. The seropositivity of Gimpo-si showed a strong linear relationship with the API of 2005 (r=0.9983, P=0.036). Seropositivity data obtained using IFAT may be useful for understanding malaria prevalence of relevant years, predicting future transmission of malaria, and for establishing and evaluating malaria control programs in affected areas.
Antibodies, Protozoan/*blood ; Fluorescent Antibody Technique, Indirect ; Humans ; Incidence ; Malaria, Vivax/*epidemiology ; Plasmodium vivax/*immunology ; Republic of Korea/epidemiology ; Seroepidemiologic Studies

Background/Aims: Recent data indicate the presence of liver enzyme abnormalities in patients with coronavirus disease 2019 (COVID-19). We aimed to evaluate the clinical features and treatment outcomes of COVID-19 patients with abnormal liver enzymes. Methods: We performed a retrospective, multicenter study of 874 COVID-19 patients admitted to five tertiary hospitals from February 20 to April 14, 2020. Data on clinical features, laboratory parameters, medications, and treatment outcomes were collected until April 30, 2020, and compared between patients with normal and abnormal aminotransferases. Results: Abnormal aminotransferase levels were observed in 362 patients (41.1%), of which 94 out of 130 (72.3%) and 268 out of 744 (36.0%) belonged to the severe and non-severe COVID-19 categories, respectively. The odds ratios (95% confidence interval) for male patients, patients with a higher body mass index, patients with severe COVID-19 status, and patients with lower platelet counts were 1.500 (1.029 to 2.184, p=0.035), 1.097 (1.012 to 1.189, p=0.024), 2.377 (1.458 to 3.875, p=0.001), and 0.995 (0.993 to 0.998, p>0.001), respectively, indicating an independent association of these variables with elevated aminotransferase levels. Lopinavir/ ritonavir and antibiotic use increased the odds ratio of abnormal aminotransferase levels after admission (1.832 and 2.646, respectively, both p<0.05). The median time to release from quarantine was longer (22 days vs 26 days, p=0.001) and the mortality rate was higher (13.0% vs 2.9%, p<0.001) in patients with abnormal aminotransferase levels. Conclusions Abnormal aminotransferase levels are common in COVID-19 patients and are associated with poor clinical outcomes. Multivariate analysis of patients with normal aminotransferase levels on admission showed that the use of lopinavir/ritonavir and antibiotics was associated with abnormal aminotransferase levels; thus, careful monitoring is needed.

Background/Aims: Recent data indicate the presence of liver enzyme abnormalities in patients with coronavirus disease 2019 (COVID-19). We aimed to evaluate the clinical features and treatment outcomes of COVID-19 patients with abnormal liver enzymes. Methods: We performed a retrospective, multicenter study of 874 COVID-19 patients admitted to five tertiary hospitals from February 20 to April 14, 2020. Data on clinical features, laboratory parameters, medications, and treatment outcomes were collected until April 30, 2020, and compared between patients with normal and abnormal aminotransferases. Results: Abnormal aminotransferase levels were observed in 362 patients (41.1%), of which 94 out of 130 (72.3%) and 268 out of 744 (36.0%) belonged to the severe and non-severe COVID-19 categories, respectively. The odds ratios (95% confidence interval) for male patients, patients with a higher body mass index, patients with severe COVID-19 status, and patients with lower platelet counts were 1.500 (1.029 to 2.184, p=0.035), 1.097 (1.012 to 1.189, p=0.024), 2.377 (1.458 to 3.875, p=0.001), and 0.995 (0.993 to 0.998, p>0.001), respectively, indicating an independent association of these variables with elevated aminotransferase levels. Lopinavir/ ritonavir and antibiotic use increased the odds ratio of abnormal aminotransferase levels after admission (1.832 and 2.646, respectively, both p<0.05). The median time to release from quarantine was longer (22 days vs 26 days, p=0.001) and the mortality rate was higher (13.0% vs 2.9%, p<0.001) in patients with abnormal aminotransferase levels. Conclusions Abnormal aminotransferase levels are common in COVID-19 patients and are associated with poor clinical outcomes. Multivariate analysis of patients with normal aminotransferase levels on admission showed that the use of lopinavir/ritonavir and antibiotics was associated with abnormal aminotransferase levels; thus, careful monitoring is needed.