The objective of this study was to investigate the prevalence of tick-borne pathogens in the Korean water deer (Hydropotes inermis argyropus). Pathogens were identified using PCR which included Anaplasma, Ehrlichia, Rickettsia, and Theileria. Rickettsia was not detected, whereas Anaplasma, Ehrlichia, and Theileria infections were detected in 4, 2, and 8 animals, respectively. The most prevalent pathogen was Theileria. Of the 8 Theileria-positive animals, 2 were mixed-infected with 3 pathogens (Anaplasma, Ehrlichia, and Theileria) and another 2 animals showed mixed-infection with 2 pathogens (Anaplasma and Theileria). Sequencing analysis was used to verify the PCR results. The pathogens found in this study were identified as Anaplasma phagocytophilum, Ehrlichia canis, and Theileria sp. To the best of our knowledge, this is the first report identifying these 3 pathogens in the Korean water deer. Our results suggest that the Korean water deer may serve as a major reservoir for these tick-borne pathogens, leading to spread of tick-borne diseases to domestic animals, livestock, and humans. Further studies are needed to investigate their roles in this respect.
Anaplasma/isolation & purification ; Animals ; Bacterial Infections/epidemiology/microbiology/*veterinary ; Cluster Analysis ; Coinfection/epidemiology/microbiology/veterinary ; DNA, Bacterial/chemistry/genetics ; DNA, Ribosomal/chemistry/genetics ; Ehrlichia/*isolation & purification ; Korea/epidemiology ; Molecular Sequence Data ; Phylogeny ; Prevalence ; RNA, Ribosomal, 16S/genetics ; Rickettsia/*isolation & purification ; Ruminants/*microbiology ; Sequence Analysis, DNA ; Theileria/*isolation & purification

BACKGROUND: To date, there are few data on the risk factors for severe cases and deaths associated with the 2009 pandemic H1N1 influenza A. Here, we describe the clinical and epidemiologic characteristics of patients hospitalized for pneumonia and identify those factors associated with the development of major complications (MC). METHODS: We reviewed the medical records of 41 cases of pneumonia admitted to a university-affiliated tertiary hospital between Aug 26 and Dec 10, 2009, and who had confirmed H1N1 influenza A based on real-time reverse transcriptase-polymerase-chain-reaction assay. There were 7,962 patients that fit these criteria. We compared the clinical features and demographic characteristics of patients who developed MC to with those who did not develop MC. RESULTS: During the study period, 10 patients developed MC (required admission to the intensive care unit, n=10; required ventilator therapy, n=6; death, n=4). Patients with MC were significantly older than those without MC and more frequently had underlying medical conditions (90.0% vs 41.9%, p-value <0.01). In the patients with developed MC, the median PaO2/FiO2 ratio of 230.0 (145.0~347.3) at admission and pneumonia severity index (PSI) score of 141.5 (88.3~158.5) were higher than patients without MC. However, no differences were observed in laboratory findings or in viral shedding between the 2 groups. CONCLUSION: In hospitalized pneumonia patients of 2009 H1N1 influenza, old age, a history of malignancy, initial hypoxemia, PaO2/FiO2 ratio, and PSI score appear to be risk factor significantly related to developing MC. These findings might be the basis to influence strategies for admitting patients to an intensive or intermediate care unit and for pre-emptive antiviral therapy.
Anoxia ; Critical Illness ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; Intensive Care Units ; Medical Records ; Pandemics ; Pneumonia ; Risk Factors ; Tertiary Care Centers ; Ventilators, Mechanical ; Virus Shedding

Interferons play critical roles in tumor pathogenesis by controlling apoptosis and through cellular anti-proliferative and differentiation activities. Interferon inducible transmembrane protein (IFITM) family genes have been implicated in several cellular processes such as the homotypic cell adhesion functions of IFN and cellular anti-proliferative activities. Expression levels of IFITM genes have been found to be up-regulated in gastric cancer cells and colorectal tumors. IFITM3 (also known as 1-8U) is a member of the IFITM family, and has been described as a key player in specification of germ cell fate. IFITM3 was first isolated from a genetic screen aimed at identifying genes involved in acquisition of germ cell competence. It has been proposed that epiblast cells have the highest expression of IFITM3 initiated germ cell specification and that homotypic association can discriminate germ cells from their somatic neighbors. In an attempt to better understand the genetic influences of IFITM3 on ulcerative colitis, we have identified possible variation sites and single nucleotide polymorphisms (SNPs) through two exons and their boundary IFITM3 intron sequences including the ~2.1 kb promoter regions. To determine whether or not these IFITM3 SNPs are associated with susceptibility to ulcerative colitis, frequencies of the genotype and allele of IFITM3 polymorphisms were analyzed on genomic DNAs isolated from patients with ulcerative colitis and from healthy controls. We also investigated the haplotype frequencies constructed by these SNPs in both groups. In this study, we also showed that expression level of IFITM3 mRNA was significantly higher in tissues of the ileum and cecum of the digestive system. We identified a total of seven SNPs and multiple variation regions in the IFITM3 gene. The genotype frequency of the g.-204T>G polymorphism in patients with ulcerative colitis was significantly different from that of the control group. Our results strongly suggest that polymorphisms of the IFITM3 gene may be associated with susceptibility to ulcerative colitis.
Cecum/*metabolism ; Colitis, Ulcerative/epidemiology/*genetics/immunology ; Gene Expression Profiling ; Gene Frequency ; Genetic Association Studies ; Genetic Predisposition to Disease ; Haplotypes ; Ileum/*metabolism ; Korea ; Membrane Proteins/*genetics/immunology/metabolism ; Organ Specificity ; Polymorphism, Single Nucleotide ; RNA-Binding Proteins/*genetics/immunology/metabolism

BACKGROUND: The changes in the pulmonary function observed in burn patients with an inhalation injury are probably the result of a combination of airway inflammation, chest wall and muscular abnormalities, and scar formation. In addition, it appears that prolonged ventilatory support and an episode of pneumonia contribute to the findings. This study investigated the changes in the pulmonary function in patients with inhalation injury at the early and late post-burn periods. METHODS: From August 1, 2002, to August 30, 2005, surviving burn patients who had an inhalation injury were enrolled prospectively. An inhalation injury was identified by bronchoscopy within 48hours after admission. Spirometry was performed at the early phase during admission and the recovery phase after discharge, and the changes in the pulmonary function were compared. RESULTS: 37 patients (M=28, F=9) with a total burn surface area (% TBSA), ranging from 0 to 18%, were included. The initial PaO2/FiO2ratio and COHb were 286.4+/-129.6 mmHg and 7.8+/-6.6 %. Nine cases (24.3%) underwent endotracheal intubation and 3 cases (8.1%) underwent mechanical ventilation. The initial X-ray findings revealed abnormalities in, 18 cases (48.6%) with 15 (83.3%) of these being completely resolved. However, 3 (16.7%) of these had residual sequela. The initial pulmonary function test, showed an obstructive pattern in 9 (24.3%) with 4 (44.4%) of these showing a positive bronchodilator response, A restrictive pattern was also observed in 9 (24.3%) patients. A lower DLco was observed in only 4 (17.4%) patients of which 23 had undergone DLco. In the follow-up study, an obstructive and restrictive pattern was observed in only one (2.7%) case each. All the decreased DLco returned to mormal. CONCLUSIONS: Most surviving burn patients with an inhalation injury but with a small burn size showed initial derangements in the pulmonary function test that was restored to a normal lung function during the follow up period.
Bronchoscopy ; Burns ; Cicatrix ; Follow-Up Studies ; Humans ; Inflammation ; Inhalation* ; Intubation, Intratracheal ; Lung ; Pneumonia ; Prospective Studies ; Respiration, Artificial ; Respiratory Function Tests* ; Spirometry ; Thoracic Wall

The eotaxin gene family (eotaxin, eotaxin-2 and eotaxin-3) have been implicated in the recruitment of eosinophils, basophiles and helper T (Th) 2 lymphocytes that is a central aspect of allergic disease. We previously suggested that Eo2+179T>C and Eo2 +275C>T of the eotaxin-2, and Eo3 +2497T>G of the eotaxin-3 were significantly associated with susceptibility to asthma. To determine whether the single nucleotide polymorphisms (SNPs) of eotaxin-2 and eotaxin-3 gene family are associated with the susceptibility of ulcerative colitis (UC), we analyzed the genotype of 119 patients with UC and 303 controls using single-base extension (SBE) method. We also calculated the haplotype frequencies among Eo2 +179T>C and Eo2 +275C >T of the eotaxin-2 and Eo3 +2497T>G of the eotaxin-3 in both control and UC patients. The genotype frequency of Eo2 +179T>C and Eo2 +275C>T between UC patients and controls were significantly different (P=0.006 and 0.022, respectively). The genotype and allele frequencies of EoA2497T>G in UC patients were not significantly different from those in the controls without UC patients. Our results suggest that Eo2 +179T>C and Eo2 +275C>T of eotaxin-2 might be associated with the susceptibility of UC.
Adult ; Alleles ; Asian Continental Ancestry Group/*genetics ; Case-Control Studies ; Chemokines, CC/*genetics ; Colitis, Ulcerative/ethnology/*genetics ; Female ; Genetic Predisposition to Disease/*genetics ; Haplotypes ; Humans ; Korea ; Male ; Middle Aged ; Polymorphism, Genetic/*genetics ; Research Support, Non-U.S. Gov't

BACKGROUND: We examined global gene expression profiles of peripheral blood mononuclear cells (PBMCs) in patients with ulcerative colitis (UC), and tested whether the identified genes with the altered expression might be associated with susceptibility to UC. METHODS: PBMCs from 8 UC and 8 normal healthy (NH) volunteers were collected, and total RNAs were subjected to the human 8.0K cDNA chip for the microarray analysis. Real time-PCR (RT-PCR) was performed to verify the results of microarray. One hundred forty UC patients and 300 NH controls were recruited for single nucleotide polymorphism (SNP) analysis. RESULTS: Twenty-five immune function-related genes with over 2-fold expression were identified. Of these genes, two chemokines, namely, CXCL1 and CCL20, were selected because of their potential importance in the evocation of host innate and adaptive immunity. Four SNPs were identified in the promoter and coding regions of CXCL1, while there was no significant difference between all patients with UC and controls in their polymorphisms, except minor association at g.57A< G (rs2071425, p=0.02). On the other hand, among three novel and one known SNPs identified in the promoter region of CCL20, g.-1,706 G< A (p=0.000000055), g.-1,458 G< A (p=0.0048), and g.-962C< A (p=0.0006) were found to be significantly associated with the susceptibility of UC. CONCLUSION: Altered gene expression in mononuclear cells may contribute to IBD pathogenesis. Although the findings need to be confirmed in other populations with larger numbers of patients, the current results demonstrated that polymorphisms in the promoter region of CCL20 are positively associated with the development of UC.
Adaptive Immunity ; Chemokines ; Clinical Coding ; Colitis, Ulcerative* ; Crohn Disease ; DNA, Complementary ; Gene Expression ; Hand ; Humans ; Inflammatory Bowel Diseases ; Microarray Analysis ; Polymorphism, Single Nucleotide ; Promoter Regions, Genetic* ; RNA ; Transcriptome ; Ulcer* ; Volunteers

The infectious complications after renal transplantation remain as an important causes of both mortality and graft loss. The lung is the most common target for post-transplant infection. We analyzed the causative agents, treatments and outcomes of post-transplant pulmonary infections. From 1990 to 1998, 192 renal allografts were performed at Hallym University Hospital. Seven cases (3.6%) of 5 males and 2 females developed serious pulmonary infections and required hospitalization. The mean age was 42.6 years. The onsets of pulmonary infections were from a month to 6 months in 3 cases, from 6 months to a year in one case and after a year in 3 cases. Triple therapy regimen was used in 4 cases as an immunosuppression therapy. Acute rejections developed in 6 cases. Causative organisms were Cytomegalovirus in 2 cases, Mycobacteria in 2 cases, Aspergillus in a case, Nocardia in a case and unknown in a case. Despite appropriate antibiotics, four patients did not respond to the treatment and died. The early recognition of infection and appropriate therapy is important to reduce fatal consequence.
Allografts ; Anti-Bacterial Agents ; Aspergillus ; Cytomegalovirus ; Female ; Hospitalization ; Humans ; Immunosuppression ; Kidney Transplantation* ; Kidney* ; Lung ; Male ; Mortality ; Nocardia ; Transplants

BACKGROUND: The level of imposed work of breathing (WOB) is important for patient-ventilator synchrony and during weaning from mechanical ventilation. Triggering methods and the sensitivity of demand system are important determining factors of the imposed WOB. Flow triggering method is available on several modem ventilator and is believed to impose less work to a patient-triggered breath than pressure triggering method. We intended to compare the level of imposed WOB on two different methods of triggering and also at different levels of sensitivities on each triggering method (0.7 L/min vs 2.0 L/min on flow triggering ; -1 cmH2O vs -2 cm H2O on pressure triggering). METHODS: The subjects were 12 patients (64.8α4.2 yrs) on mechanical ventilation and were stable in respiratory pattern on CPAP 3 cmH2O. Four different triggering sensitivities were applied at random order. For determination of imposed WOB, tracheal end pressure was measured through the monitoring lumen of Hi-Lo Jet tracheal tube (Mallincrodt, New York, USA) using pneumotachograph/pressure transducer (CP-100 pulmonary monitor, Bicore, Irvine, CA, USA). Other data of respiratory mechanics wert also obtained by CP-100 pulmonary monitor. RESULTS: The imposed WOB was decreased by 37.5% during 0.7 L/min on flow triggering compared to -2 cmH2O on pressure triggering and also decreased by 14% during -1 cmH2O compared to -2 cmH2O on pressure triggering (p<0.05 in each). The PTP(Pressure Time Product) was also decreased significantly during 0.7 L/min on flow triggering and -I cmH2O on pressure triggering compared to -2 cmH2O on pressure triggering(p<0.05 in each). The proportions of imposed WOB in total WOB were ranged from 37% to 85% and no significant changes among different methods and sensitivities. The physiologic WOB showed no significant changes among different triggering methods and sensitivities. CONCLUSION: To reduce the imposed WOB, flow triggering with sensitivity of 0.7 L/min would be better method than pressure triggering with sensitivity of -2 cm H2O.
Humans ; Modems ; Respiration, Artificial* ; Respiratory Mechanics ; Transducers ; Ventilation* ; Ventilators, Mechanical ; Weaning ; Work of Breathing*

BACKGROUND: Massive hemoptysis is one of the major medical emergency with high risk of mortality. Though the best predictor of mortality associated with hemoptysis appears to be the amount of bleeding within the first 24 hours, catastrophic hemorrhage could be occurred to the patients who were apparently in a stable condition with scanty hemoptysis at the time of admission. We evaluated APACHE III score system to find if it could be a prognostic index that can predict the mortality of the patients with hemoptysis. METHODS: We identified all the patients who had admitted with hemoptysis in the Medical Intensive Care Unit of Asan Medical Center between May 25, 1989, and July 31, 1995. A retrospective analysis was done in 66 patients with hemoptysis on APA- CHE III score. RESULTS: The overall mortality rate was 17.4% (12/69). In univariate analysis of possible prognostic factors, independent predictors of mortality were age(P=0.016), amount of hemoptysis(P=0.012), AaDO2 (P=0.017), requirement of transfusion(P=0.036), mechanical ventilatory care(P<0.05) and APACHE III score(P=0.02), In multivariate analysis with sex, age, amount of hemoptysis, AaDO2, requirement of transfusion and APACHE III score, APACHE III score was the only independent predictor of mortality(P=0.015, odd ratio=19.3, 95% confidence interval, 3.4 to 249.7) CONCLUSION: APACHE IU score may be a clinically significantly important independent predictor of outcome in the patients with hemoptysis. In addition, invasive procedure, such as bronchial artery embolizaticn or operation, could be considered in advance in the patients with more than 30 points of APACHE III.
APACHE* ; Bronchial Arteries ; Chungcheongnam-do ; Emergencies ; Hemoptysis* ; Hemorrhage ; Humans ; Intensive Care Units* ; Critical Care* ; Mortality ; Multivariate Analysis ; Prognosis ; Retrospective Studies

The postmortem stature was measured in 57 Korean adult males (age range: 20-86 years old, mean: 52.3 years old) in supine position. After dissection of the corpses, we measured the maximum length of the remaining limb-bones (humerus, radius, ulna, femur, tibia and fibula). The correlation coefficients between the stature and each limb-bone length were calculated. Simple regression equations for estimating stature from each limb-bone length and multiple regression equations from the combination of limb-bone lengths were also obtained.
Adult ; Aged ; Aged, 80 and over ; Body Height* ; Bone and Bones/anatomy & histology* ; Extremities/anatomy & histology* ; Human ; Male ; Middle Age ; Regression Analysis