Background: Pathogenic Escherichia coli (PEC) is a leading cause of acute diarrhea worldwide. With increasing antibiotic use, antimicrobial resistance in PEC has become a significant public health concern. In this study, we investigated the distribution and antimicrobial susceptibility patterns of PEC isolated from patients with acute diarrhea in the Busan and Gyeongnam regions of South Korea. Methods: In this retrospective cross-sectional laboratory-based study, 272 PCR-positive residual stool or rectal swab specimens collected between October 2023 and June 2024 were screened; after exclusion of 80 specimens without recoverable or confirmable isolates, 192 pathogenic E. coli isolates were included for pathotype identification and antimicrobial susceptibility testing. Pathotypes were identified using multiplex real-time polymerase chain reaction, and antimicrobial susceptibility was tested against 18 agents using the VITEK II system. Results: Enteroaggregative E. coli (EAEC) was the most prevalent pathotype (44.8%), followed by enteropathogenic E. coli (34.9%). High resistance rates were observed for ampicillin (77.1%), cefazolin (55.2%), and amoxicillin/clavulanic acid (44.3%). EAEC demonstrated the highest multidrug resistance (MDR) rate (34.9%). Pediatric patients (< 18 years) exhibited significantly higher resistance rates and MDR frequencies compared with adults, particularly against β-lactam antibiotics. Conclusion EAEC was identified as the predominant and most resistant pathotype in this region. The elevated resistance levels in children and the prevalence of MDR EAEC underscore the need for continuous local surveillance and appropriate antibiotic stewardship.

Purpose: The purpose of this study was to identify the concordant or discordant genomic profiling between primary and matched metastatic tumors in patients with colorectal cancer (CRC) and to explore the clinical implication. Materials and Methods: Surgical samples of primary and matched metastatic tissues from 158 patients (335 samples) with CRC at Korea University Anam Hospital were evaluated using the Ion AmpliSeq Cancer Hotspot Panel. We compared genetic variants and classified them as concordant, primary-specific, and metastasis-specific variants. We used a combination of principal components analysis and clustering to find genomic groups. Kaplan-Meier curves were used to appraise survival between genomic groups. We used machine learning to confirm the correlation between genetic variants and metastatic sites. Results: A total of 282 types of deleterious non-synonymous variants were selected for analysis. Of a total of 897 variants, an average of 40% was discordant. Three genomic groups were yielded based on the genomic discrepancy patterns. Overall survival differed significantly between the genomic groups. The poorest group had the highest proportion of concordant KRAS G12V and additional metastasis-specific SMAD4. Correlation analysis between genetic variants and metastatic sites suggested that concordant KRAS mutations would have more disseminated metastases. Conclusion Driver gene mutations were mostly concordant; however, discordant or metastasis-specific mutations were present. Clinically, the concordant driver genetic changes with additional metastasis-specific variants can predict poor prognosis for patients with CRC.

BACKGROUND: This study aimed to compare the indicators (the rates of diagnosis, need for treatment, treatment initiation, and treatment completion) of management of latent tuberculosis infection (LTBI) in contacts and to identify the impact of active tuberculosis (TB) index case characteristics on the exposed population in congregated settings, such as schools, workplaces, and medical institutes. METHODS: The data of 8,648 clusters in the TB epidemiological investigation database between 2013 and 2016 were extracted and analyzed to evaluate the indicators and perform multilevel logistic regression (MLR) analyses to identify the factors affecting each indicator. RESULTS: The rates of total LTBI diagnosis, need for treatment, treatment initiation, and treatment completion were 15.2%, 10.2%, 69.4%, and 76.6%, respectively. After adjusting for other factors on MLR, the probability of diagnosis and need for treatment of latent TB in contacts was higher in most types of facilities than in schools. Conversely, treatment completion rates in these facilities were lower. Notably, the correctional institutions showed the highest odds ratio (OR) relative to school for LTBI diagnosis (OR, 6.37) and need for treatment (OR, 4.49) and the lowest OR for treatment completion (OR, 0.10). CONCLUSION: This study provided evidence for the implementation of latent TB control policies in congregated settings.
Academies and Institutes ; Diagnosis ; Humans ; Korea ; Latent Tuberculosis ; Logistic Models ; Odds Ratio ; Tuberculosis

Gitelman syndrome is characterized by hypokalemia, metabolic alkalosis, hypocalciuria, and hypomagnesemia. The clinical course of Gitelman syndrome in pregnant women remains unclear, but it is thought to be benign. We report here the first Korean case of atypical eclampsia in a 31-year-old who was diagnosed with Gitelman syndrome incidentally during an antenatal screening test. The patient did well during pregnancy despite significant hypokalemia. At 33 weeks’ gestation, the patient exhibited eclampsia, hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome, and renal insufficiency without significant hypertension or proteinuria. We explain this unusual clinical course through a review of the relevant literature.
Adult ; Alkalosis ; Eclampsia ; Female ; Gitelman Syndrome* ; HELLP Syndrome* ; Hemolysis ; Humans ; Hypertension ; Hypokalemia ; Liver ; Pregnancy ; Pregnant Women ; Prenatal Diagnosis ; Proteinuria ; Renal Insufficiency

A 45-year-old man presented with dyspnea and hemoptysis during exercise. A chest computed tomography (CT) revealed multifocal diffuse patchy ground glass opacity and interlobular septal thickening in both the lungs. Permeability pulmonary edema or pulmonary hemorrhage was suspected. Serologic studies for autoimmune disorders and vasculitis were negative. There was no laboratory evidence of coagulopathy, other hematopoietic disease or infectious disease. Considering correlation with exercise, we diagnosed exercise-induced pulmonary hemorrhage (EIPH) or exercise-induced pulmonary edema (EIPE). The patient was managed with antifibrinolytics, antibiotics, and antitussive agent. After a week, follow-up chest CT revealed completely resolved pulmonary hemorrhage. About 2 months after the first event, he visited again with dyspnea and hemoptysis during running. In the present study, we report a case of recurrent pulmonary hemorrhage after exercise.
Anti-Bacterial Agents ; Antifibrinolytic Agents ; Communicable Diseases ; Dyspnea* ; Follow-Up Studies ; Glass ; Hemoptysis* ; Hemorrhage ; Humans ; Lung ; Middle Aged* ; Permeability ; Pulmonary Edema ; Running ; Thorax ; Tomography, X-Ray Computed ; Vasculitis

Patients referred to the Veterinary Medical Center at Chungbuk National University were analyzed. This study aimed to provide information to clinicians in Korea on the factors affecting fracture incidence in patients adapted to Korean companion animal culture. Eighty cases showing-bone fractures were investigated from January, 2005 to December, 2011. Fractures were mainly observed in miniature dogs such as Yorkshire terrier (12%), Poodle (12%), and Maltese (9%). Almost 50% of all cases were less than 1 year old. Total bone fractures in summer and fall constituted 62%. Fracture incidence was higher in male dogs (54%) than female dogs (46%). Hindlimb fracture (37%) was the most common. Distribution of limb fractures was higher in the femur (19), followed by the tibia/fibula (15), radius/ulna (13), humerus (11), and mandible (8). Pelvic fracture was observed in 19 cases. Simple fracture (84%) was the most common fracture type, followed by comminuted fracture (16%). Distal portion was the most common fracture site in long bones (67%), followed by middle (26%) and proximal bones (7%). Fractures were mainly caused by traffic accidents (43%), whereas 28.5% of fractures were due to falling down. Plate & screw (26%) was the most common method of fracture repair, followed by intramedullary pin (24%), wire (11%), external skeletal fixation (10%), screw (9%), amputation (7%), cross pin (6%), IM pin and wire (5%), and rush pin (1%). Among 80 patients, 79%of patients showed a good prognosis after surgery, whereas 13% patients did not experience a good result. This study shows that miniature dogs are prone to falling and fractures, especially in the distal part of long bones.
Accidents, Traffic ; Amputation ; Animals ; Dogs* ; Extremities ; Female ; Femur ; Fracture Fixation ; Fractures, Bone ; Fractures, Comminuted ; General Surgery ; Hindlimb ; Humans ; Humerus ; Incidence ; Korea ; Male ; Mandible ; Pets ; Prognosis ; Retrospective Studies*