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.

Previously, the majority of human embryonic stem cells and human induced pluripotent stem cells have been derived on feeder layers and chemically undefined medium. Those media components related to feeder cells, or animal products, often greatly affect the consistency of the cell culture. There are clear advantages of a defined, xeno-free, and feeder-free culture system for human pluripotent stem cells (hPSCs) cultures, since consistency in the formulations prevents lot-to-lot variability. Eliminating all non-human components reduces health risks for downstream applications, and those environments reduce potential immunological reactions from stem cells. Therefore, development of feeder-free hPSCs culture systems has been an important focus of hPSCs research. Recently, researchers have established a variety of culture systems in a defined combination, xeno-free matrix and medium that supports the growth and differentiation of hPSCs. Here we described detailed hPSCs culture methods under feeder-free and chemically defined conditions using vitronetin and TeSR-E8 medium including supplement bioactive lysophospholipid for promoting hPSCs proliferation and maintaining stemness.
Animals ; Cell Culture Techniques ; Embryonic Stem Cells ; Extracellular Matrix ; Feeder Cells ; Human Embryonic Stem Cells ; Humans ; Induced Pluripotent Stem Cells ; Pluripotent Stem Cells ; Stem Cells

The authors regret that one co-author (Kyung-Hyo Kim) was missing in the article.

BACKGROUND: Invasive bacterial infections in apparently immunocompetent children were retrospectively analyzed to figure causative bacterial organisms in Korea. METHODS: A total of 947 cases from 25 university hospitals were identified from 2006 to 2010 as a continuance of a previous 10-year period study from 1996 to 2005. RESULTS: Escherichia coli (41.3%), Streptococcus agalactiae (27.7%), and Staphylococcus aureus (27.1%) were the most common pathogens in infants < 3 months of age. S. agalactiae was the most prevalent cause of meningitis and pneumonia and E. coli was the major cause of bacteremia without localizing signs in this group. In children 3 to 59 months of age, Streptococcus pneumoniae (54.2%), S. aureus (20.5%), and Salmonella spp. (14.4%) were the most common pathogens. S. pneumoniae was the leading cause of pneumonia (86.0%), meningitis (65.0%), and bacteremia without localizing signs (49.0%) in this group. In children ≥ 5 years of age, S. aureus (62.8%) was the predominant pathogen, followed by Salmonella species (12.4%) and S. pneumoniae (11.5%). Salmonella species (43.0%) was the most common cause of bacteremia without localizing signs in this group. The relative proportion of S. aureus increased significantly over the 15-year period (1996–2010) in children ≥ 3 months of age (P < 0.001), while that of Haemophilus influenzae decreased significantly in both < 3 months of age group (P = 0.036) and ≥ 3 months of age groups (P < 0.001). CONCLUSION: S. agalactiae, E. coli, S. pneumoniae, and S. aureus are common etiologic agents of invasive bacterial infections in Korean children.
Bacteremia ; Bacterial Infections ; Child ; Epidemiology ; Escherichia coli ; Haemophilus influenzae ; Hospitals, University ; Humans ; Infant ; Korea ; Meningitis ; Pneumonia ; Retrospective Studies ; Salmonella ; Staphylococcus aureus ; Streptococcus agalactiae ; Streptococcus pneumoniae

Central precocious puberty (CPP) is caused by premature activation of hypothalamic gonadotropin-releasing hormone (GnRH) secretion. Kisspeptin and G-protein coupled receptor-54 system is the essential gatekeeper of the reproductive system, playing a key role in the activation of the gonadotropic axis at puberty. We aimed to determine whether serum kisspeptin may function as a marker for CPP by investigating serum kisspeptin levels in Korean girls with CPP and their prepubertal controls. Serum kisspeptin levels of Korean girls with CPP (n = 30) and age-matched healthy prepubertal controls (n = 30) were measured with a competitive enzyme immunoassay. Serum kisspeptin levels were significantly higher in CPP group than in control group (4.61 +/- 1.78 vs 2.15 +/- 1.52 pM/L, P < 0.001). Serum kisspeptin was positively correlated with peak luteinizing hormone (LH), peak/basal LH ratio and peak LH/follicular-stimulating hormone (FSH) ratio during GnRH stimulation test. CPP is supposed to be triggered by premature increase of kisspeptin. Serum kisspeptin may be used as a marker of CPP. Further studies on KISS1 gene polymorphisms leading to higher risk of premature increase of kisspeptin and upstream regulator of kisspeptin are also needed.
Biological Markers/blood ; Child ; Female ; Follicle Stimulating Hormone/blood ; Humans ; Luteinizing Hormone/blood ; Puberty, Precocious/blood/*diagnosis ; Republic of Korea ; Tumor Suppressor Proteins/*blood

PURPOSE: Fracture of the frontal sinus accounts for 5-15% of all facial fractures. Only anterior table fracture occupies one third of the frontal sinus fracture. Conventional coronal approach is the standard treatment, but this method is very aggressive, especially in patient with simple, depressed, anterior frontal sinus wall fracture. We introduce new, simple technique for these patients, using small incision and Dual-top screws. METHODS: A 27-year-old male patient was introduced to our department under the impression of fracture of frontal sinus, involving only anterior table. Under general anesthesia, 1.5cm-sized, small incision was made on the suprabrow area. We reduced fractured fragment with two dual-top screws and 25G wires. Fixation was not necessary RESULTS: The operation took about forty minutes, and the patient discharged 2 days after the operation. Postoperative 2 months follow up CT shows maintenance of reduction site. Gross depression of the forehead and visible scar was not observed. CONCLUSION: Although the indication of this procedure is limited, less aggressive, simple and very effective to the patient with simple. depressed, anterior frontal sinus fracture.
Adult ; Anesthesia, General ; Cicatrix ; Depression ; Follow-Up Studies ; Forehead ; Frontal Sinus ; Humans ; Male

The conventional surgery method of thrombectomy of venous thrombi from the deep veins of the lower extremity was the use of Forgarty balloon catheter. The catheter is inconvenient due to the presence of the balloon and prohibiting venous valves within the venous trees. With the use of a stone-forceps(Fig. 1), thrombi within iliofemoral vein could be easily removed without the obstacle of the valves because the instrument keeps valves open. This instrument is also useful in monitoring the back-flow from the iliac vein. Thrombi within the veins below the level of inguinal incision are removed successfully only by effective manual compression of the calf and thigh muscles. I recommend operating on the iliac vein first rather than the lower venous tree.
Catheters ; Iliac Vein ; Lower Extremity* ; Muscles ; Thigh ; Thrombectomy ; Veins* ; Venous Thrombosis ; Venous Valves

Diverse developments in the field of tissue engineering have stimulated much research on tissue production. However, studies on fat tissue still remain insufficient. The purpose of this study is to examine if alginate gel and collagen gel can be used as a three-dimensional scaffold for the culture of preadipocytes, and if these gels can induce preadipocytes to differentiate into mature adipocytes. The preadipocytes harvested from rat epididymal fat pads were three-dimensionally cultured in 1%, 2% alginate gel and collagen gel for 14 days. The morphology, number, and activity of preadipocytes were examined during the experimental period. The results were as follows; 1. The preadipocytes of monolayer culture were spindle shape with rich cytoplasm. The preadipocytes of collagen gel were multipolar or star-like in shape and there was no oil-red 0 stained cell until 14 days. However, the preadipocytes in alginate gel were round and some of cells transformed into mature fat cells which were stained by oil-red 0 after 14 days. 2. The number of preadipocytes in collagen gel continuously increased for 14 days, and significantly increased compared to that of preadipocytes in monolayer culture after 7 days. However, the number of preadipocytes in alginate gel significantly decreased compared to that of preadipocytes in monolayer culture and collagen gel for 14 days, and there was no difference between 1% and 2% alginate gel groups in the number of preadipocytes. 3. The activity of preadipocytes in collagen gel was decreased until 7 days, but not significantly different after 10 days, when compared with that of preadipocytes in monolayer culture. And the activity of preadipocytes in alginate gel was decreased than that of preadipocytes in monolayer culture until 10 days, was higher than that of preadipocytes in collagen gel until 7 days, but was not significantly different compared with that of preadipocytes in monolayer culture and collagen gel on the 14th day. There was no difference between 1% and 2% alginate gel groups in activity of preadipocytes for 14 days. The results suggest that collagen gel are adequate three-dimensional scaffolds in which the proliferation of preadipocytes can be induced, and that alginate gel can be used as a three-dimensional scaffold that has the ability to induce differentiation of preadipocyte although the proliferation of preadipocytes is inhibited.
Adipocytes ; Adipose Tissue ; Animals ; Collagen* ; Cytoplasm ; Gels* ; Rats ; Tissue Engineering

BACKGROUND: The authors have modified the method of Ravitch technique. MATERIAL AND METHOD: This technique was applied to 6 patients out of 18 patients who underwent corrective surgery from May 1987 to July 1999. The technique is quite different from that of Ravitch. We did not divide the intercostal muscle bundles from the laterals of sternum and the Akin's struts were placed retrosternally crossing the chest horizontally to prevent flail motion during immediate post-operative period and retraction of the sternum afterwards. Anterior sternal osteotomy instead of the posterior one was performed for the latest 3 cases which made operative procedure more simple and easy. The struts were removed one year later. RESULT: Compared to the hospital stay of the patients who received standard Ravitch method that of the six cases who received our modification was definitely shortened from 13.1 days to 8.3 days(p<0.0000). Flail motion was not noted in any patient and chest wall stability was obtained more easily with this technique. CONCLUSION: Our modification is recommendable for correction of funnel chest in regards to shorter operation time better chest wall stability shorter hospital stay and less complication.
Funnel Chest* ; Humans ; Intercostal Muscles ; Length of Stay ; Osteotomy ; Sternum ; Surgical Procedures, Operative ; Thoracic Wall ; Thorax

BACKGROUND: Post-intubation injury is known to be the most common cause of tracheal stenosis. Treatment strategy for tracheal stenosis varies accoring to the extent of pathologic lesion. Focal mucosal lesion can be treated with laser photoablation, but full thickness tracheal lesion should be treated with resection and anastomosis. MATERIAL AND METHOD: From Aptil 1998 to May 1999, twelve patients suffering from tracheal stenosis as a complication of endotracheal intubation were managed by resection and end-to-end anastomosis in the Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital. RESULT: There was no operative mortality. Five temporary vocal cord paralysis and one wound infection occurred as early complications. During 18 months of follow-up, re-stenosis was not found. CONCLUSION: Tracheal resection and anastomosis can be considered as an excellent surgical treatment for tracheal stenosis which developed as a complication of endotracheal intubation.
Follow-Up Studies ; Humans ; Intubation, Intratracheal ; Mortality ; Tracheal Stenosis* ; Vocal Cord Paralysis ; Wound Infection