Background: Group A streptococcus (GAS) is the most common cause of bacterial pharyngitis. This study aimed to characterize the molecular epidemiology of GAS infection using an emm-typing and emm-clustering approach. Methods: A total of 372 patients from Changwon who showed pharyngitis symptoms were recruited during the sampling period of 2018–2019 and throat cultures were obtained from them. emm typing was performed using polymerase chain reaction (PCR) and direct sequencing. emm genotypes and GAS clusters were classified based on a web-based database. Results: Of the 372 throat swab specimens, 101 (27.2%) were positive for GAS. emm typing analysis was performed on 59 GAS isolates. The most prevalent emm type was emm89 (20.3%), followed by emm12 (16.9%). Seven emm clusters were identified: E4 (emm89/ emm28, 32.2%), A-C4 (emm12, 16.9%), E1 (emm4, 13.6%), A-C5 (emm3, 10.2%), E6 (emm75, 8.5%), M6 (emm6, 8.5%), and A-C3 (emm1, 6.8%). Conclusion Diverse and temporal changes were observed in the distribution of emm types and clusters of GAS. Continuous surveillance based on emm genotyping is needed to monitor the epidemiological characteristics of GAS pharyngitis.

No abstract available.
Blood Volume

Background: Blood culture is essential for diagnosis of sepsis. However, usually the available blood volume is not sufficient to meet the guidelines. Thus, periodic monitoring and feedback are essential to improve the quality of blood cultures. Methods: We analyzed blood cultures requested between November 2018 and June 2019, and provided educational intervention and coaching for phlebotomists at the end of February 2019. Then, we evaluated the impact of education on blood cultures in a secondary­‑­care hospital. Blood volume, positive rate, contamination rate, and time to detection (TTD) were compared between the pre- (November 2018 to February, 2019) and post-intervention periods (March to June, 2019). Results: The average blood volume increased significantly from 5.4 mL to 7.1 mL (P < 0.0001) (35.2%) after intervention. Accordingly, the proportion of optimal blood volume (8–12 mL) increased from 9.1% to 37.8% (P < 0.0001). Before the intervention, the positivity rate was 9.6% and the contamination rate was 0.5%, whereas after the intervention, the positivity rate decreased to 9.1% and the contamination rate increased to 1.1%. TTD improved from 14.7 hours to 13.1 hours (P = 0.0420). Conclusion The educational intervention of the phlebotomy team improved the quality of blood cultures, especially blood volumes and TTD. However, the positivity rate did not increase, suggesting that it is affected not only by the blood volumes but also by the severity of the underlying illnesses of the patient in a secondary-care hospital.

The effects of kainic acid-induced seizures on GABA and GABA transporter in the rat cerebellum were examined by means of immunohistochemical and Western blot methods. Immunocytochemical analysis showed that kainic acid-induced seizures led to a decreased immunoreactivity for GABA to 3 weeks after seizures with an slight increase in the immunoreactivity of cerebellum 24 h after treatment. Immunoreactivities of GABA transporters, GAT-1 and GAT-3 which are localized neurons and astrocytes, were increased at 24 and 48h and after that weak immunoreactivites for GABA transporters were shown in the cerebellar tissues. Our results indicate that kainic acid-induced seizures exerts specific effects on GABA contents and the GABA transporters in the cerebellum and a decrease of GABA contents might not always associated with the decrease in the number of GABA transporters in the rat cerebellum.
Animals ; Astrocytes ; Blotting, Western ; Cerebellum* ; GABA Plasma Membrane Transport Proteins ; gamma-Aminobutyric Acid* ; Kainic Acid ; Neurons ; Rats* ; Seizures*

Background: Pharyngitis is one of the most common conditions encountered in primary health care facilities. Accurate differentiation of group A streptococcus (GAS) infection from viral infection is difficult. The STANDARD F Strep A Ag FIA (SD BIOSENSOR, Korea) is a rapid antigen detection test (RADT) that has been recently developed for diagnosing GAS pharyngitis. In this study, we evaluated the diagnostic performance of the STANDARD F Strep A Ag FIA and compared the results between the RADT and conventional throat culture. Methods: Throat swab samples were obtained from a total of 372 children presenting pharyngitis symptoms in five pediatric clinics in Changwon, Korea from July 2018 to October 2019. A comparative study between STANDARD F Strep A Ag FIA and Sofia Strep A FIA (Quidel, USA) was performed. Two throat swabs were taken simultaneously from each patient for RADT. The third throat swab was stored in a transport tube containing Stuart's transport medium for culture. Performance and kappa index of STANDARD F Strep A Ag FIA were evaluated. Results: GAS infection was detected in 29.3% (109/372) patients, using the STANDARD F Strep A Ag FIA. The sensitivity, specificity, positive predictive value, and negative predictive value were 95.0%, 95.2%, 88.1%, and 98.1%, respectively. The STANDARD F Strep A Ag FIA showed an excellent concordance rate of 96.5% and a kappa value of 0.89 compared to Sofia Strep A FIA. Conclusion The STANDARD F Strep A Ag FIA demonstrated an excellent performance along with Sofia Strep A FIA for the diagnosis of GAS pharyngitis.

Ischiofemoral impingement (IFI) syndrome is an uncommon cause of gluteal and hip pain. We report on a case of a 20-year-old man who presented with chronic gluteal and hip pain with low back pain without a history of trauma or surgery. He was misdiagnosed with ankylosing spondylitis (AS) at another clinic. The patient was finally diagnosed with IFI syndrome according to pelvic magnetic resonance imaging findings at our hospital. After two weeks of medical and physical treatment, his pain showed gradual improvement. Because IFI syndrome is rarely reported in male patients, it might be misdiagnosed as AS. Therefore, IFI syndrome should be considered as a differential diagnosis of AS, particularly in young male patients with atypical pain characteristics.
Diagnosis, Differential* ; Hip ; Humans ; Low Back Pain ; Magnetic Resonance Imaging ; Male ; Spondylitis, Ankylosing* ; Young Adult

Background: The clindamycin-resistant erythromycin-susceptible (CRES) phenotype is rare in Streptococcus agalactiae (group B streptococci). We aimed to determine the molecular characteristics of CRES S. agalactiae using whole genome sequencing (WGS). Methods: Sixty-six S. agalactiae isolates obtained from blood (N=26), cerebrospinal fluid (N=10), urine (N=17), and vaginal discharge (N=13) between 2010 and 2017 in Korea were subjected to WGS. Based on the WGS data, we analyzed antimicrobial resistance (AMR) determinants, sequence types (STs), capsular polysaccharide (CPS) genotypes, and virulence gene profiles, and constructed a phylogenetic tree. We included the clindamycin-susceptible erythromycin-resistant (CSER) phenotype for comparison. Results: We identified seven CRES S. agalactiae isolates from urine (N=5) and vaginal discharge (N=2) collected between 2010 and 2011. All CRES isolates harbored AMR determinants of lnu(B), lsa(E), and aac(6’)-aph(2’’), revealed ST19 and CPS genotype III, and had a virulence gene profile of rib-lmb-cylE. Phylogenetic tree analysis revealed that all CRES isolates belonged to the same cluster, suggesting a clonal distribution. In contrast, seven CSER isolates showed a diverse distribution and clustered separately from the CRES isolates. Conclusions CRES isolates collected between 2010 and 2011 showed a unique cluster with ST19 and CPS genotype III in Korea. This is the first report on WGS-based characteristics of S. agalactiae in Korea.

No abstract available.
Carcinoid Tumor* ; Proctitis*

No abstract available.
Carcinoid Tumor* ; Proctitis*

This study was conducted to evaluate the usefulness of coronary arterial profiles from normal dogs (11 animals) and canines (six dogs) with experimental myocardial infarction (MI) induced by ligation of the left coronary artery (LCA). Blood velocity of the LCA and right coronary artery (RCA) were evaluated following transthoracic pulsed-wave Doppler echocardiography. The LCA was observed as an infundibular shape, located adjacent to the sinus of Valsalva. The RCA appeared as a tubular structure located 12 o'clock relative to the aorta. In normal dogs, the LCA and RCA mean peak diastolic velocities were 20.84 +/- 3.24 and 19.47 +/- 2.67 cm/sec, respectively. The LCA and RCA mean diastolic deceleration times were 0.91 +/- 0.14 sec and 1.13 +/- 0.20 sec, respectively. In dogs with MI, the LCA had significantly (p < 0.01) lower peak velocities (14.82 +/- 1.61 cm/sec) than the RCA (31.61 +/- 2.34 cm/sec). The RCA had a significantly (p < 0.01) rapid diastolic deceleration time (0.71 +/- 0.06 sec) than that found in the LCA (1.02 +/- 0.22 sec) of MI dogs. In conclusion, these profiles may serve as a differential factor for evaluating cardiomyopathy in dogs.
Animals ; Blood Flow Velocity/*veterinary ; Coronary Vessels/surgery/*ultrasonography ; Dog Diseases/*diagnosis ; Dogs/*physiology ; Echocardiography, Doppler, Pulsed/standards/*veterinary ; Female ; Male ; Myocardial Infarction/diagnosis/*veterinary