The flaviviruses are small single-stranded RNA viruses that are typically transmitted by mosquitoes or tick vectors and are etiological agents of acute zoonotic infections. The viruses are found around the world and account for significant cases of human diseases. We investigated population of culicine mosquitoes in central region of Korean Peninsula, Incheon Metropolitan City and Hwaseong-si. Aedes vexans nipponii was the most frequently collected mosquitoes (56.5%), followed by Ochlerotatus dorsalis (23.6%), Anopheles spp. (10.9%), and Culex pipiens complex (5.9%). In rural regions of Hwaseong, Aedes vexans nipponii was the highest population (62.9%), followed by Ochlerotatus dorsalis (23.9%) and Anopheles spp. (12.0%). In another rural region of Incheon (habitat of migratory birds), Culex pipiens complex was the highest population (31.4%), followed by Ochlerotatus dorsalis (30.5%), and Aedes vexans vexans (27.5%). Culex pipiens complex was the predominant species in the urban region (84.7%). Culicine mosquitoes were identified at the species level, pooled up to 30 mosquitoes each, and tested for flaviviral RNA using the SYBR Green-based RT-PCR and confirmed by cDNA sequencing. Three of the assayed 2,683 pools (989 pools without Anopheles spp.) were positive for Culex flaviviruses, an insect-specific virus, from Culex pipiens pallens collected at the habitats for migratory birds in Incheon. The maximum likelihood estimation (the estimated number) for Culex pipiens pallens positive for Culex flavivirus was 25. Although viruses responsible for mosquito-borne diseases were not identified, we encourage intensified monitoring and long-term surveillance of both vector and viruses in the interest of global public health.

In malaria, splenic rupture is a serious complication potentially leading to death. Subcapsular hemorrhage of spleen is thought to be an impending sign of splenic rupture; however, the characteristics of subcapsular hemorrhage are not well known. We report 3 cases of subcapsular hemorrhage of the spleen in vivax malaria, with varying degrees of severity. Case 1 showed subcapsular hemorrhage without splenic rupture, was treated by antimalarial drug without any procedure. The healing process of the patient's spleen was monitored through 6 computed tomography follow-up examinations, over 118 days. Case 2 presented subcapsular hemorrhage with splenic rupture, treated only with an antimalarial drug. Case 3 showed subcapsular hemorrhage with splenic rupture and hypotension, treated using splenic artery embolization. They all recovered from subcapsular hemorrhage without any other complications. These 3 cases reveal the process of subcapsular hemorrhage leading to rupture and a potentially fatal outcome. The treatment plan of subcapsular hemorrhage should be determined carefully considering the vital signs, changes in hemoglobin, and bleeding tendency.
Fatal Outcome ; Follow-Up Studies ; Hemorrhage ; Hypotension ; Malaria ; Malaria, Vivax ; Plasmodium vivax ; Rupture ; Spleen ; Splenic Artery ; Splenic Rupture ; Vital Signs

PURPOSE: Deep venous thrombosis (DVT) and pulmonary embolism (PE) are considered as similar disease entities representing different clinical manifestations. The objectives of this study were: 1) to determine the prevalence and outcome of DVT in patients with PE; 2) to identify additional risk factors for PE-related unfavorable outcome and 30-day all-cause mortality; and 3) to establish the clinical importance of screening for concomitant DVT. MATERIALS AND METHODS: From January 2013 to December 2015, a total of 141 patients with confirmed PE were evaluated. The prevalence and outcome of DVT in patients with PE was determined. Furthermore, the potential risk factors for PE-related unfavorable outcome and 30-day all-cause mortality were also analyzed. RESULTS: The prevalence of concomitant DVT was 45.4%. PE-related unfavorable outcome was observed in 21.9% of all concomitant DVT, with all-cause mortality of 21.9%. There was no significant relationship between the presence of concomitant DVT and the development of PE-related unfavorable outcome or all-cause mortality. Our results indicated that heart rate >100/min and peripheral oxygen saturation <90% were independent predictors for PE-related unfavorable outcome. Regarding all-cause mortality, active malignancy and hypotension or shock were significant risk factors. CONCLUSION: Our findings demonstrate that approximately half of patients with PE possess DVT. However, this study failed to establish any clinical significance of concomitant DVT for PE-related unfavorable outcome and all-cause mortality. Tachycardia and hypoxemia were identified as significant predictors for PE-related unfavorable outcome along with active malignancy and hypotension or shock as significant risk factors of all-cause mortality.
Anoxia ; Heart Rate ; Humans ; Hypotension ; Mass Screening ; Mortality ; Oxygen ; Prevalence ; Pulmonary Embolism* ; Risk Factors ; Shock ; Tachycardia ; Venous Thrombosis*

PURPOSE: Stress during pregnancy is a risk factor for the development of anxiety-related disorders in offspring later in life. The effects of treadmill exercise on anxiety-like behaviors and hippocampal cell proliferation were investigated using rats exposed to prenatal stress. METHODS: Exposure of pregnant rats to a hunting dog in an enclosed room was used to induce stress. Anxiety-like behaviors of offspring were evaluated using the elevated plus maze test. Immunohistochemistry for the detection of 5-bromo-2'-deoxyuridine and doublecortin (DCX) in the hippocampal dentate gyrus and 5-hydroxytryptamine 1A receptors (5-HT(1A)) in the dorsal raphe was conducted. Brain-derived neurotrophic factor (BDNF) and tyrosine kinase B (TrkB) levels in the hippocampus were evaluated by western blot analysis. RESULTS: Offspring of maternal rats exposed to stress during pregnancy showed anxiety-like behaviors. Offspring also showed reduced expression of BDNF, TrkB, and DCX in the dentate gyrus, decreased cell proliferation in the hippocampus, and reduced 5-HT(1A) expression in the dorsal raphe. Postnatal treadmill exercise by offspring, but not maternal exercise during pregnancy, enhanced cell proliferation and expression of these proteins. CONCLUSIONS: Postnatal treadmill exercise ameliorated anxiety-like behaviors in offspring of stressed pregnant rats, and the alleviating effect of exercise on these behaviors is hypothesized to result from enhancement of cell proliferation through 5-HT(1A) activation in offspring rats.
Animals ; Anxiety* ; Blotting, Western ; Brain-Derived Neurotrophic Factor ; Bromodeoxyuridine ; Cell Proliferation* ; Dentate Gyrus ; Dogs ; Dorsal Raphe Nucleus ; Exercise Test ; Hippocampus ; Immunohistochemistry ; Pregnancy ; Prenatal Exposure Delayed Effects ; Protein-Tyrosine Kinases ; Rats* ; Receptor, Serotonin, 5-HT1A* ; Risk Factors ; Serotonin*

PURPOSE: In the treatment of breast cancer, neoadjuvant chemotherapy (NAC) is useful to reduce breast cancer size before surgical intervention. Patients who achieve a pathologic complete response (pCR) to NAC have improved overall survival (OS). However, the relationship between prognosis and partial response is yet unclear. In this study, we evaluated prognostic factors and the tumor response ratio (TRR) method among patients who received NAC. METHODS: Clinicopathologic factors were evaluated to predict OS. The TRR was calculated by dividing pathologic tumor size by clinical tumor size. TRRs were then categorized into four groups, and the survival times for the different TRR groups were compared using statistical evaluation. RESULTS: Clinical N stage (p=0.02), overall stage (p=0.04), pathologic N stage (p=0.03), hormone receptor status (p=0.01), and lymphovascular invasion (p=0.02) were significantly associated with OS. Pathologic overall stage and TRR did not correlate with OS. Patients with a pCR exhibited the best survival rates using the current staging system and the TRR method. CONCLUSION: Clinicopathologic factors can be easily applied to predict OS, and clinicians could use these parameters until an accurate, simple, and highly discriminatory methods is developed to assess breast cancer patients with a partial.

PURPOSE: This study analyzed the clinical and radiological long-term follow-up results of patients with femoral head fracture who received surgical treatments. MATERIALS AND METHODS: Retrospective evaluation was performed for 20 patients with femoral head fracture who received surgical treatments between December 1997 and May 2010. According to Pipkin's classification, there were five type I, six type II, one type III, and eight type IV fractures. RESULTS: The average Merle d'Aubigne'-Postel score was 12.8 (12.80+/-3.53). According to surgical method, the score for the bony fragment excision group was 9.8 (9.83+/-2.79), and that for the open reduction and internal fixation group was 13.9 (13.92+/-3.07). Depending on Thompson-Epstein criteria, two patients were good, two were fair, and two were poor in the bony fragment excision group. Four patients were excellent, six were good, and three were poor in the open reduction and internal fixation group. CONCLUSION: Bony fragment excision should be performed with caution in patients with femoral head fracture. Considering fragment size, location, and presence of acetabular fracture, better outcome can be expected using the open reduction and internal fixation method in comparison with excision.
Acetabulum ; Classification ; Follow-Up Studies ; Head* ; Hip Joint ; Humans ; Retrospective Studies

The purpose of this study was to investigate the therapeutic effects of DA-9801, an optimized extract of Dioscorea species, on diabetic peripheral neuropathy in a type 2 diabetic animal model. In this study, db/db mice were treated with DA-9801 (30 and 100 mg/kg, daily, p.o.) for 12 weeks. DA-9801 reduced the blood glucose levels and increased the withdrawal latencies in hot plate tests. Moreover, it prevented nerve damage based on increased nerve conduction velocity and ultrastructural changes. Decrease of nerve growth factor (NGF) may have a detrimental effect on diabetic neuropathy. We previously reported NGF regulatory properties of the Dioscorea genus. In this study, DA-9801 induced NGF production in rat primary astrocytes. In addition, it increased NGF levels in the sciatic nerve and the plasma of type 2 diabetic animals. DA-9801 also increased neurite outgrowth and mRNA expression of Tieg1/Klf10, an NGF target gene, in PC12 cells. These results demonstrated the attenuation of diabetic peripheral neuropathy by oral treatment with DA-9801 via NGF regulation. DA-9801 is currently being evaluated in a phase II clinical study.
Animals ; Astrocytes ; Blood Glucose ; Diabetes Mellitus, Type 2 ; Diabetic Neuropathies ; Dioscorea* ; Mice* ; Models, Animal ; Nerve Growth Factor ; Neural Conduction ; Neurites ; PC12 Cells ; Peripheral Nervous System Diseases* ; Plasma ; Rats ; RNA, Messenger ; Sciatic Nerve

Plasmodium vivax reemerged in the Republic of Korea (ROK) in 1993, and is likely to continue to affect public health. The purpose of this study was to measure levels of anti-P. vivax antibodies using indirect fluorescent antibody test (IFAT) in border areas of ROK, to determine the seroprevalence of malaria (2003-2005) and to plan effective control strategies. Blood samples of the inhabitants in Gimpo-si, Paju-si, and Yeoncheon-gun (Gyeonggi-do), and Cheorwon-gun (Gangwon-do) were collected and kept in Korea Centers for Disease Control and Prevention (KCDC). Out of a total of 1,774 serum samples tested, the overall seropositivity was 0.94% (n=17). The seropositivity was the highest in Paju-si (1.9%, 7/372), followed by Gimpo-si (1.4%, 6/425), Yeoncheon-gun (0.67%, 3/451), and Cheorwon-gun (0.19%, 1/526). The annual parasite incidence (API) in these areas gradually decreased from 2003 to 2005 (1.69, 1.09, and 0.80 in 2003, 2004, and 2005, respectively). The highest API was found in Yeoncheon-gun, followed by Cheorwon-gun, Paju-si, and Gimpo-si. The API ranking in these areas did not change over the 3 years. The seropositivity of Gimpo-si showed a strong linear relationship with the API of 2005 (r=0.9983, P=0.036). Seropositivity data obtained using IFAT may be useful for understanding malaria prevalence of relevant years, predicting future transmission of malaria, and for establishing and evaluating malaria control programs in affected areas.
Antibodies, Protozoan/*blood ; Fluorescent Antibody Technique, Indirect ; Humans ; Incidence ; Malaria, Vivax/*epidemiology ; Plasmodium vivax/*immunology ; Republic of Korea/epidemiology ; Seroepidemiologic Studies

PURPOSE: We retrospectively analyzed long-term clinical results after two-stage revision arthroplasty using an antibiotic-impregnated cement spacer for infected total hip arthroplasty. MATERIALS AND METHODS: Twenty-six hips (group 1: cup exchanged, group 2: cup and stem exchanged) were enrolled in this study. The mean follow-up period was 7.4 years (5 to 11 years). We analyzed the laboratory findings, the time interval between antibiotic-impregnated cement spacer insertion and revision arthroplasty, Harris hip score, Oxford hip score, radiologic changes, and recurrence of infection. RESULTS: Revision hip arthroplasty was performed at 7.5 weeks on average (group 1: 7.2 weeks, group 2: 7.7 weeks) after implant removal and cement spacer insertion. In group 1, Harris hip score was 51.1 points preoperatively, 84.4 points at six months, 89.3 points in at one year, 91.8 points at three years, and 89.8 points at five years. In group 2, the Harris hip score was 49.8 points preoperatively, 78.1 points at six months, 83.7 points at one year, 90.3 points at three years, and 88.7 points at five years. Recurrence of infection developed in one hip in each group. CONCLUSION: Ninety-two percent of infected hips were eradicated with two-stage revision arthroplasty using an antibiotic-impregnated cement spacer for infected hip arthroplasty at minimum five-year follow-up. When the infection was limited to the hip joint and the stem was fixed well, two-stage revision with stem retained could be a good treatment option.
Arthroplasty* ; Arthroplasty, Replacement, Hip ; Follow-Up Studies ; Hip Joint ; Hip* ; Recurrence ; Retrospective Studies

PURPOSE: The purpose of this study was to analyze the effectiveness of coracoclavicular screw fixation with tension band wiring in the treatment of displaced distal clavicle fractures. MATERIALS AND METHODS: From October 2006 to December 2010, 18 patients with Neer type 2 displaced distal clavicle fracture were surgically treated. Fixation was performed, using coracoclavicular screw with tension band wiring. Radiographic and clinical evaluation was performed and the University of California at Los Angeles (UCLA) shoulder rating scale was employed for the assessment of shoulder joint function. RESULTS: Osseous union was achieved approximately 9.5 weeks (8-11 weeks) in all patients. After the union, the screw and wire were removed under local anesthesia. All patients returned to the normal shoulder range of motion. Loosening of the screw was seen in two patients and breakage was seen in one patient. However, we could not observe the delayed union and complications, such as infection and refracture. All but one patient showed excellent results according to the UCLA shoulder score at one year after the operation. CONCLUSION: Coracoclavicular screw fixation with tension band wiring in the treatment of displaced distal clavicle fractures is a clinically useful technique with good result and less complication.
Anesthesia, Local ; California ; Clavicle ; Humans ; Los Angeles ; Range of Motion, Articular ; Shoulder ; Shoulder Joint