No abstract available.

OBJECTIVE: This investigation was performed to uncover the nature of the clinical drug trials in the past in Korean psychiatry and to prepare some guidelines for the good clinical practice in the future. METHOD: We reviewed total 212 papers of the clinical drug trials in the major Korean psychiatric journals from April 1962 to December 1998. RESULTS: From the year 1985, when the pharmacological and biological organizations in psychiatry were found in our country, the clinical drug trials are rapidly expanding. Although open clinical trials in small sample size less than 30 subjects were the most frequent in the past, some well-designed clinical trials such as multicenter double-blind cross-over study were performed recently. Majority of these 212 clinical trials was done in patients with schizophrenia and mood disorders. Haloperidol was just the drug most frequently evaluated in the clinical trials in our country. As expected, among several clinical rating scales, Brief Psychiatric Rating Scale was the most frequently used. Prolactin and homovanillic acid were the materials frequently measured in the patients with schizophrenia. A few of these clinical trials were performed under the financial supports from the industry, and only one biological research had gained a fund from a national academic institute. To evaluate the researchers' concepts for the medical ethics in the clinical drug trials, we reviewed the description about the informed consent and the approval of institutional review board in all papers. Surprisingly, we found no descriptions about the informed consent in 113 papers(65.8%). Only one clinical trial was performed after the approval of the institutional review board. CONCLUSIONS: We confirmed that the majority of the clinical psychiatric drug trials in the past were performed in lacks of the concept of Good Clinical Practice(GCP). The KGCP guideline did not influenced on the researchers' concepts and performance for the medical ethics at all. Although all of the clinical trials may not need to be done under the guidelines of GCP, clinical researchers' efforts for the medical ethics should be continued for both, the patient and the researcher.
Brief Psychiatric Rating Scale ; Cross-Over Studies ; Ethics Committees, Research ; Ethics, Medical ; Financial Management ; Financial Support ; Haloperidol ; Homovanillic Acid ; Humans ; Informed Consent ; Korea* ; Mood Disorders ; Prolactin ; Sample Size ; Schizophrenia ; Weights and Measures

In the present study, the outbreak patterns of bovine brucellosis in Korea from 2000 to 2011 were analyzed to understand the epidemiological evolution of this disease in the country. A total of 85,521 brucella reactor animals were identified during 14,215 outbreaks over the 12-year study period. The number of bovine brucellosis cases increased after 2003 and peaked in 2006 before decreasing thereafter. The majority of the bovine brucellosis cases were Korean native cattle, Han Woo. The numbers of human brucellosis cases and cattle outbreaks increased and decreased in the same pattern. The correlation coefficient for human and bovine cases per year was 0.96 (95% confidence interval = 0.86~0.99; p < 10(-3)). The epidemiological characteristics of bovine brucellosis appeared to be affected by the intensity of eradication programs that mainly involved a test-and-slaughter policy. Findings from the present study were based on freely available statistics from web pages maintained by government agencies. This unlimited access to information demonstrates the usefulness of government statistics for continually monitoring the health of animal populations.
Animals ; Brucellosis/epidemiology/virology ; Brucellosis, Bovine/*epidemiology/microbiology ; Cattle ; Disease Outbreaks/*veterinary ; Humans ; Republic of Korea

Marfan's syndrome is a an autosomal dominant disorder of connective tissue that is characterized by ocular, skeletal, and cardiovascular manifestation. It is estimated to have a prevalence of 4-6 per 10,000 people, and at least 25 percent of the cases occur in the absence of a family history. Coronary artery ectasia is a diffuse abnormality of the vessel wall, which has been reported in associated with coronary atherosclerosis, infectious process, congenital heart lesion, syphilis, Ehlers-Danlos syndrome. We reported a case of 25-year-old male who presented with Marfan's syndrome associated with dissecting ascending arotic aneurysm and diffuse dilatated coronary artery ectasia. Coronary angiographic study demonstrated the diffusely dilatated coronary artery ectasia.
Adult ; Aneurysm ; Connective Tissue ; Coronary Artery Disease ; Coronary Vessels* ; Dilatation, Pathologic* ; Ehlers-Danlos Syndrome ; Heart ; Humans ; Male ; Marfan Syndrome* ; Prevalence ; Syphilis

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

In upper gastrointestinal endoscopy, intravenous anesthesia is commonly used due to its safety and improvement in patient's satisfaction and comfort. The aim of this approach is to improve the condition for endoscopy. Although the risks of sedation are reported to be very low with sufficient monitoring, we still have few risks that cannot be overlooked including aspiration pneumonia. There have been two reported cases of aspiration pneumonia after endoscopic submucosal dissection. However, to our knowledge, there has been no reports about aspiration pneumonia developing after endoscopy for a young healthy female. So, we report a first case of unexpected aspiration pneumonia after endoscopy.
Anesthesia, Intravenous ; Endoscopy ; Endoscopy, Gastrointestinal* ; Female ; Humans ; Pneumonia, Aspiration*

We report a case of anal squamous cell carcinoma extended to the rectal mucosa that was clinically mistaken for rectal adenocarcinoma and literature reviwed. Sigmoidoscopic finding showed spherical shaped elevated lesion with central ulceration, interpreted as rectal adenocarcinoma in the distal portion of rectum. Anal squamous cell carcinoma is very rare among gastrointestinal cancer. Pathological study of the biopsy specimen demonstrated squamous cell carcinoma and normal rectal glands. Sigmoidoscopic finding of the presented case showed the ulcerarive lesion contineuosly extended from anal verge upward to the rectum. We postulate that the presented case is primarilly originated from the anal squamous cell carcinoma extended proximally to the rectum. Immunohistochemical stain(p-63) of the biopsy specimens showed squamous cell carcinoma. This patient has been completely recovered after treartment of chemoradiation and trans-anal excision. We present a case of anal squamous cell carcinoma invading rectal mucosa clinically mistaken for rectal adenocarcinoma and literature reviewed.
Adenocarcinoma* ; Anus Neoplasms ; Biopsy ; Carcinoma, Squamous Cell* ; Gastrointestinal Neoplasms ; Humans ; Mucous Membrane ; Rectum ; Salt Gland ; Ulcer

Mycobacterium (M.) bovis causes tuberculosis and has a broad host range, including humans, livestock, and wild animals. M. bovis infection of wild boar has been reported in several European countries. We report here the first case of M. bovis infection in a domesticated wild sow in Korea. Granulomatous and necrotizing lesions with small numbers of acid-fast bacilli were observed in nodules of the lung of wild sow. Furthermore, the M. bovis isolate from the wild sow had spoligotype SB0140 and a novel MIRU-VNTR allelic profile, which is not found in cattle and deer in Korea.
Animals ; Animals, Wild ; Cattle ; Deer ; Host Specificity ; Humans ; Korea* ; Livestock ; Lung ; Mycobacterium bovis* ; Mycobacterium* ; Sus scrofa ; Tuberculosis

BACKGROUND: Limited data on the incidence and clinical characteristics of adult pertussis infections are available in Korea. METHODS: Thirty-one hospitals and the Korean Centers for Disease Control and Prevention collaborated to investigate the incidence and clinical characteristics of pertussis infections among adults with a bothersome cough in non-outbreak, ordinary outpatient settings. Nasopharyngeal aspirates or nasopharyngeal swabs were collected for polymerase chain reaction (PCR) and culture tests. RESULTS: The study enrolled 934 patients between September 2009 and April 2011. Five patients were diagnosed as confirmed cases, satisfying both clinical and laboratory criteria (five positive PCR and one concurrent positive culture). Among 607 patients with cough duration of at least 2 weeks, 504 satisfied the clinical criteria of the US Centers for Disease Control and Prevention (i.e., probable case). The clinical pertussis cases (i.e., both probable and confirmed cases) had a wide age distribution (45.7+/-15.5 years) and cough duration (median, 30 days; interquartile range, 18.0~50.0 days). In addition, sputum, rhinorrhea, and myalgia were less common and dyspnea was more common in the clinical cases, compared to the others (p=0.037, p=0.006, p=0.005, and p=0.030, respectively). CONCLUSION: The positive rate of pertussis infection may be low in non-outbreak, ordinary clinical settings if a PCR-based method is used. However, further prospective, well-designed, multicenter studies are needed.
Adult ; Age Distribution ; Centers for Disease Control and Prevention (U.S.) ; Cough ; Dyspnea ; Humans ; Incidence ; Outpatients ; Polymerase Chain Reaction ; Sputum ; Whooping Cough

Objectives: The Korea Centers for Disease Control and Prevention has published “A Guideline for Unknown Disease Outbreaks (UDO).” The aim of this report was to introduce tabletop exercises (TTX) to prepare for UDO in the future. Methods: The UDO Laboratory Analyses Task Force in Korea Centers for Disease Control and Prevention in April 2018, assigned unknown diseases into 5 syndromes, designed an algorithm for diagnosis, and made a panel list for diagnosis by exclusion. Using the guidelines and laboratory analyses for UDO, TTX were introduced. Results: Since September 9th , 2018, the UDO Laboratory Analyses Task Force has been preparing TTX based on a scenario of an outbreak caused by a novel coronavirus. In December 2019, through TTX, individual missions, epidemiological investigations, sample treatments, diagnosis by exclusions, and next generation sequencing analysis were discussed, and a novel coronavirus was identified as the causal pathogen. Conclusion Guideline and laboratory analyses for UDO successfully applied in TTX. Conclusions drawn from TTX could be applied effectively in the analyses for the initial response to COVID-19, an ongoing epidemic of 2019 - 2020. Therefore, TTX should continuously be conducted for the response and preparation against UDO.