BACKGROUND: We attempted to determine the characteristics of diarrheal pathogens according to species, seasonal variations, and patient age using multiplex PCR for the epidemiologic study of diarrheal disease in Jeju Island. METHODS: From March 2015 to Feb 2017, stool specimens were collected from 537 diarrheal patients older than 16 years. Multiplex PCR was used to identify pathogens and found Group A Rotavirus, enteric Adenovirus, Norovirus GI/GII, Astrovirus, Salmonella spp., Shigella spp., Vibrio spp., Campylobacter spp., Clostridium difficile toxin B (CDB), Clostridium perfringens, Yersinia enterocolitica, Aeromonas spp., Escherichia coli O157:H7, and verocytotoxin-producing E. coli (VTEC). RESULTS: Pathogens were isolated from 221 of 537 samples (41.2%); 9.3% were positive only for viral pathogens; 30.2%, only for bacterial pathogens; and 1.7%, for both viral and bacterial pathogens. Bacteria were more prevalent in spring, summer, and autumn, but viral pathogens were more prevalent in winter. Overall prevalence were Campylobacter spp. (26.7%), Clostridium perfringens (23.9%); Norovirus GII (11.4%), CDB (8.2%), Aeromonas spp. (6.3%), Group A Rotavirus (5.1%), Salmonella spp. (3.9%), Astrovirus (3.9%), Norovirus GI (3.1%), Vibrio spp (2.7%), enteric Adenovirus (1.6%), Shigella spp. (1.2%), VTEC (1.2%), and Yersinia enterocolitica (0.4%). Group A Rotavirus and Norovirus GII were more prevalent in winter and early spring. Campylobacter spp., CDB, and C. perfringens were detected frequently, without seasonal variation. CONCLUSION: Bacterial pathogens are more prevalent than viruses in acute diarrhea in adults living in Jeju Island, especially in spring, summer, and autumn. Viral pathogens are prevalent in winter. Campylobacter spp., CDB, and Clostridium perfringens are the major pathogens occurring without seasonal variations. These data will be helpful in identifying diarrheal pathogens and for treatments and prevention strategies.
Adenoviridae ; Adult* ; Aeromonas ; Bacteria ; Campylobacter ; Clostridium difficile ; Clostridium perfringens ; Diarrhea ; Epidemiologic Studies* ; Epidemiology ; Escherichia coli ; Humans ; Multiplex Polymerase Chain Reaction* ; Norovirus ; Prevalence ; Rotavirus ; Salmonella ; Seasons ; Shiga-Toxigenic Escherichia coli ; Shigella ; Vibrio ; Yersinia enterocolitica

BACKGROUND: Streptococcus agalactiae (Group B streptococcus, GBS) is known to be the leading cause of neonatal sepsis and meningitis in the United States and Europe. In addition, GBS infection has been increasingly noted in adults, particularly in those with underlying diseases, such as diabetes mellitus, malignancy and liver disease. A few studies reported that resistances to antibiotics, such as erythromycin, clindamycin, tetracycline are increasing. We report clinical and microbiological characteristics of GBS bacteremic patients in Jeju Island. METHODS: We retrospectively analyzed medical records, such as age, sex, underlying disease, mortality, skin defects, laboratory results and antibiotic resistances of GBS in hospitalized adult patients who were diagnosed with GBS bacteremia from 2008 to 2013 in Jeju Island. RESULTS: Twenty two adult patients were diagnosed as GBS bacteremia from 2008 to 2013. The mean age of GBS bacteremic patients was 66.2 years old. Of 22 bacteremic patients, fifteen patients (68%) were older than 60. Twenty patients (91%) of bacteremic patients had underlying diseases such as diabetes mellitus, malignancy and liver disease. Ten (45%) patients had skin defects which were on the lower extremities and buttock, fifteen (68%) patients had fever at the time of admission, twenty one (95%) patients were admitted via the emergency department. Two (9%) patients died. The mean white blood cell (WBC) count, percentile of neutrophil count, and C-reactive protein (CRP) levels were 11,488/microL, 84.3 %, 13.5 mg/dL respectively. All GBS isolates from bacteremia showed sensitivities to penicillin, ampicillin, and vancomycin, and showed resistances to erythromycin (25%), clindamycin (30%), and tetracycline (55%). CONCLUSION: Bacteremia caused by GBS was prevalent in adult patients with underlying diseases. Most of the GBS bacteremic patients were emergency cases, with a high body temperature, WBC, CRP level, and neutrophil count. Half of them had skin defects, which are considered a source of GBS bacteremia.
Adult* ; Ampicillin ; Anti-Bacterial Agents ; Bacteremia* ; Body Temperature ; Buttocks ; C-Reactive Protein ; Clindamycin ; Diabetes Mellitus ; Drug Resistance ; Emergencies ; Emergency Service, Hospital ; Erythromycin ; Europe ; Fever ; Humans ; Leukocytes ; Liver Diseases ; Lower Extremity ; Medical Records ; Meningitis ; Mortality ; Neutrophils ; Penicillins ; Retrospective Studies ; Sepsis ; Skin ; Streptococcus agalactiae* ; Streptococcus* ; Tetracycline ; United States ; Vancomycin

BACKGROUND: Mycoplasma pneumoniae (MP) is a major cause of community-acquired pneumonia in children. The particle agglutination (PA) assay is a clinical test routinely used to detect MP infection and to determine total MP antibody titers. Using this assay, however, it is difficult to differentiate between IgM and IgG antibodies. The aim of this study was to investigate the seroprevalence of MP IgM antibodies in children living in Jeju Island. METHODS: We investigated the seroprevalence of mycoplasma IgM antibodies in 1,693 patients in the age of 0-10 yr who were ordered for mycoplasma IgM antibody testing in Cheju Halla Hospital between April 2011 and March 2013. Results were classified according to age, sex and the month and year during which the samples were obtained. RESULTS: The overall positive rate for mycoplasma IgM antibody was 24.7% and was higher in females than in males (P=0.012). The positive rate was lowest in infants under 6 months of age, and gradually rose with increasing age until the age of 4 yr. A major increase in positive rates was observed between January-April of 2012 and minor cyclical increases were also observed at 2-4 month intervals during the study period. CONCLUSIONS: The seroprevalence of mycoplasma IgM antibodies rises gradually with age until the age of 4 yr. A major peak in MP IgM antibody-positive cases was observed in early 2012, with minor cyclical increases at every 2-4 months. These results will be helpful in the interpretation and diagnosis of MP in children living in Jeju Island.
Agglutination ; Antibodies* ; Child* ; Diagnosis ; Female ; Humans ; Immunoglobulin G ; Immunoglobulin M* ; Infant ; Jeju-do ; Korea ; Male ; Mycoplasma ; Mycoplasma pneumoniae* ; Pneumonia ; Pneumonia, Mycoplasma* ; Seroepidemiologic Studies*

BACKGROUND: Mycoplasma pneumoniae (MP) is a major cause of community-acquired pneumonia in children. Currently, no study exists regarding the frequency of the mycoplasmal antibody on Jeju Island. The aim of the present study was to investigate the frequency of mycoplasmal antibody among children living on Jeju Island. METHODS: From March 2009 to February 2011, the frequency of mycoplasmal antibody among 1580 pediatric (<10 years old) patients who were tested for the mycoplasmal antibody titer in Cheju Halla Hospital were retrospectively investigated. The authors also analyzed the positive rates according to age, sex, and season. RESULTS: The frequency of mycoplasmal antibody titers were 69.4% for an antibody titer >1:40, 20.8% in an antibody titer >1:320, and 10.7% in an antibody titer >1:640. The positive rates of each antibody titer were lowest in children under the age of 6 months, and the positive rates increased gradually with age until 4 years, where the frequency showed a "plateau." There were minor cyclic increases of positive rate (>1:320, >1:640) every three months from August 2009 to June 2010, and there was a major increase of positive rate (>1:320, >1:640) from July 2010 to January 2011. However, there was no positive rate cyclic pattern of mycoplasmal antibody in the lower titer (>1:40) patients. CONCLUSION: The frequency of mycoplasmal antibody titer is lowest under the age of 6 months. The positive rates rise gradually with age until the age of 4 years. The present study showed minor peaks of mycoplasmal antibody titer every three months and a major peak of mycoplasmal antibody titer. The results can be helpful for the interpretation and diagnosis of MP among pediatric patients on Jeju Island.
Antibodies ; Child ; Humans ; Mycoplasma ; Mycoplasma pneumoniae ; Pneumonia ; Pneumonia, Mycoplasma ; Retrospective Studies

PURPOSE: Phosphatase of regenerating liver-3 (PRL-3) has been associated with metastasis promotion. However, clinical applications of this association have not yet been clearly demonstrated. In this study, we evaluated the relation of PRL-3 mRNA level in primary colorectal cancer to the corresponding stage and to other clinicopathologic factors. METHODS: Two hundred forty-five patients with histologically-proven colorectal cancer underwent surgery between January 2004 and December 2006. RNA was extracted and cDNA was prepared by using reverse transcription. Quantification of PRL-3 was done using a real-time polymerase chain reaction. RESULTS: Eighty-six cases with well-preserved specimens were enrolled: 53 males and 33 females. The mean age was 63.4 years. According to tumour node metastasis (TNM) stage of the American Joint Committee on Cancer (AJCC), stage I was 11 cases, stage II was 38 cases, stage III was 23 cases, and stage IV was 14 cases. Among stage IV cases, one case was combined with liver and lung metastases, and one case was combined with liver metastases and peritoneal dissemination. The remaining stage IV patients were combined with only liver metastases. There was a significant correlation in PRL-3 mRNA expression between primary colorectal cancer and corresponding tumor stage. PRL-3 mRNA expression was increased in the liver metastases cases. Lymphatic and vascular invasion were significantly related with PRL-3 mRNA levels. CONCLUSION: Advanced stage prediction may be obtained by measuring the level of PRL-3 mRNA expression in primary colorectal cancer. Especially, the risk of liver metastases may be predicted by measuring the level of PRL-3 mRNA expression in primary colorectal cancer. Further study is required to confirm these preliminary results.
Colorectal Neoplasms ; DNA, Complementary ; Female ; Humans ; Joints ; Liver ; Lung ; Male ; Neoplasm Metastasis ; Neoplasm Proteins ; Protein Tyrosine Phosphatases ; Real-Time Polymerase Chain Reaction ; Reverse Transcription ; RNA ; RNA, Messenger

PURPOSE: Osteopontin is one of the major non-collagenous protein of hard tissue. Use of peptide domain of biologically active protein has some advantages. The objective of this experimental study is evaluation of periodontal regenerative potency of synthetic peptide gel which containing collagen binding domain of osteopontin in the degree III periodontal defect of beagle dogs. MATERIAL AND METHODS: Experimental degree III furcation defect was made in the mandibular third and fourth premolar of beagles. Regenerative material was applied during flap operation. 8 weeks after regenerative surgery, all animals were sacrificed and histomorphometric measurement was performed to calculate the linear percentage of the new cementum formation and the volume percentage of new bone formation. RESULT: The linear percent of new cementum formation was 41.6% at control group and 67.1% at test group and there was statistically significant difference. The volume percent of new bone formation was 52.1% at control group and 58.9% at test group. CONCLUSION: As the results of present experiment, synthetic peptide gel containing collagen binding domain of osteopontin significantly increase new bone and cementum formation in the degree III furcation defect of canine mandible.
Animals ; Bicuspid ; Collagen ; Dental Cementum ; Furcation Defects ; Mandible ; Osteogenesis ; Osteopontin ; Protein Structure, Tertiary ; Regeneration

BACKGROUND: Alveolar recruitment (RM) is one of the primary goals of respiratory care for an acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). The purposes of alveolar recruitment are an improvement in pulmonary gas exchange and the protection of atelectrauma. This study examined the effect and safety of the alveolar RM using pressure control ventilation (PCV) in early ALI and ARDS patients. METHODS: Sixteen patients with early ALI and ARDS who underwent alveolar RM using PCV were enrolled in this study. The patients' data were recorded at the baseline, and 20 minutes, and 60 minutes after alveolar RM, and on the next day after the maneuver. Alveolar RM was performed with an inspiratory pressure of 30 cmH2O and a PEEP of 20 cmH2O in a 2-minute PCV mode. The venous O2 saturation, central venous pressure, blood pressure, pulse rate, PaO2/FiO2 ratio, PEEP, and chest X-ray findings were obtained before and after alveolar RM. RESULTS: Of the 16 patients, 3 had extra-pulmonary ALI/ARDS and the remaining 13 had pulmonary ALI/ARDS. The mean PEEP was 11.3 mmHg, and the mean PaO2/FiO2 ratio was 130.3 before RM. The PaO2/FiO2 ratio increased by 45% after alveolar RM. The PaO2/FiO2 ratio reached a peak 60 minutes after alveolar RM. The PaCO2 increased by 51.9 mmHg after alveolar RM. The mean blood pressure was not affected by alveolar RM. There were no complications due to pressure injuries such as a pneumothorax, pneumomediastinum, and subcutaneous emphysema. CONCLUSION: In this study, alveolar RM using PCV improved the level of oxygenation in patients with an acute lung injury and acute respiratory distress syndrome. Moreover, there were no significant complications due to hemodynamic changes and pressure injuries. Therefore, alveolar RM using PCV can be applied easily and safely in clinical practice with lung protective strategy in early ALI and ARDS patients.
Acute Lung Injury* ; Blood Pressure ; Central Venous Pressure ; Heart Rate ; Hemodynamics ; Humans ; Lung ; Mediastinal Emphysema ; Oxygen ; Pneumothorax ; Pulmonary Gas Exchange ; Respiratory Distress Syndrome, Adult* ; Subcutaneous Emphysema ; Thorax ; Ventilation*

Silica is known as a promising osteoconductive material, and polycaprolactone is a bioactive and degradable material. The purpose of this study was to monitor the differentiation of MC3T3-E1 cells cultured on the layer-built silica/poly caprolactone non-woven fabric produced by electrospinning. Non-woven fabric (silica, polycaprolactone, PSP, SPS) was made by electrospinning and they were inserted in the 48 well cell culture plate. MC3T3-E1 cells were prepared by subculture. Cells were seeded to each well 1x10(5) concentration per well. Dulbecco's modified eagle medium with 10% FBS and 1% antibiotic-antimycotic solution was used. Confocal laser scanning microscope was taken 4 hours after incubation (95% air, 5% CO2, 37degrees C). Cell proliferation was monitored by spectrophotometer on 1, 7, 14 days, and the morphology of the growing cells was observed by field emission scanning electron microscope. To monitor the differentiation of osteoblasts on the materials, MC3T3-E1 cells were incubated in 48 well culture plate after seeding with the density of 1x10(5) concentration. Then ELISA kit & EIA kit were used on to assess osteocalcin and osteopontin expression respectively. The other conditions were the same as above. MC3T3-E1 cells were proliferated well on all of the materials. There were no statistical differences among them. The osteopontin expression of silica, PSP, SPS was significantly higher than other groups on day 3 (p<0.05), but after that time, there were no statistically signigicant differences. The osteocalcin expression was significantly higher in silica and PSP than other groups on day 14. These findings show that PSP was as good as silica on the effect of osteoblast differentiation. The PSP non-woven fabric may have the possibility as bone graft materials.
Cell Culture Techniques ; Cell Proliferation ; Eagles ; Enzyme-Linked Immunosorbent Assay ; Osteoblasts ; Osteocalcin ; Osteopontin ; Silicon Dioxide ; Transplants

PURPOSE: The prognosis for patients with liver metastases (LM) from colorectal cancer is significantly influenced by the clinician's decision. Recently, there have been remarkable advances in treatment of LM, so there can be some changes in therapeutic modalities. We performed a comparative study between operated and non-operated groups of patients with LM to analyze the clinical outcome. METHODS: From Feb. 2001 to Feb. 2006, 27 patients with LM underwent a hepatectomy, and 113 patients received non-surgical therapy. thirteen hepatectomized cases among the 27 patients had multiple LM. The outcomes of those 13 patients (Group A) were retrospectively compared to those of the non-operated group (Group B, n=21), which had had potentially resectable LM at the initial diagnosis or after chemotherapy, but didn't undergo hepatic resection. RESULTS: After a median follow-up duration of 31.3 months, the estimated 3-years overall survival (OS) rates were 76.9% and 14.3% in group A and B, respectively (P=0.0001). In the stepwise Cox multivariate regression analysis, factors such as the absence of hepatic resection and a greater diameter of the liver mass independently influenced the poor survival (P=0.005 and P=0.012 respectively). Additionally, two radiologists evaluated the intraoperative ultrasonographic (IOUS) results. IOUS detected new metastatic lesions in 4/13 (30%) patients. There were sub-centimeter metastatic lesions (5~7 mm) and had not been detected in SPIO-enhanced MRI. CONCLUSIONS: Our results compared to palliative chemotherapy suggest that aggressive surgical resection should be performed to increase the survival rate in patients with LM. Additionally, the treatment plan for LM patients should be discussed with the gastroenterololgist, the radiologist, the oncologist, and the surgeon.
Colorectal Neoplasms* ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Hepatectomy ; Humans ; Liver ; Magnetic Resonance Imaging ; Neoplasm Metastasis* ; Prognosis ; Retrospective Studies ; Survival Rate

The regeneration of lost periodontal tissue is a major goal of therapy. Periodontal ligament cell(PDL) is a specialized connective tissue that connects cementum and alveolar bone to maintain and support teeth in situ and preserve tissue homoeostasis. Bone morphogenetic proteins(BMPs) have shown much potential in the reconstruction of the periodontum by stimulate new bone and new cementum formation. Limitiations of BMP administration to periodontal lesions is high dose delivery, BMP transient biological activity, and low bioavailability of factors at the wound site. Gene delivery method can be alternative treatment strategy to deliver BMPs to periodontal tissue. The purpose of this study is to investigate efficiency of BMP-2 gene delivery with cell-based therapy using PDL cells. PDL cell were transduced with adenoviruses encoding either BMP-2 or Lac-Z gene. To evaluate osteogenic activity of expressed BMP-2 on PDL cells, we investigated secreted BMP-2, cellular activity, ALPase, produced mineralized nodules. To evaluate collagen scaffold as carrier for transduced cell delivery, we examined morphology and secreted BMP-2 of transducd PDL cells on it. BMP-2 transducd PDL cells produced higher levels of BMP-2, ALPase, mineralized nodules than non transduced cells. Cellular activity of transduced cells was showed similar activity to non transduced cells. Transduce cells attached on collagen scaffold secreted BMP-2 at 7day and was showed similar morphology to non transduced cells. These results demonstrated that transduced PDL cells produced biologically active BMP-2 and collagen scaffold could be carrier of transducd cells.
Adenoviridae* ; Biological Availability ; Collagen ; Connective Tissue ; Dental Cementum ; Humans* ; Periodontal Ligament* ; Regeneration ; Tooth ; Wounds and Injuries