• Journal of Yeungnam Medical Science
• /
• 제26권2호
• /
• pp.114-119
• /
• 2009

Colon cancer is the second most common malignancy in Korea. It is classified as superficial type, the mass type, the ulcerative type, the ulceroinfiltrative type, the diffuse infiltrative type and the unclassified type according to the colonoscopic findings. We report here on a case of colon cancer that was initially misdiagnosed as acute infectious colitis at the initial presentation. A 64-year-old man visited to Yeungnam University Hospital for watery diarrhea and lower abdominal pain. Colonoscopy revealed long segmental edematous mucosa and hyperemic mucosa with stenosis in the transverse colon. He was diagnosed as having acute infectious colitis according to the colonoscopic finding. However, two days later after colonoscopy, he visited the emergency room for hematochezia. We performed computerized tomography (CT) and obtained blood samples to find the origin of the bleeding. We found thickening of the transverse colon lumen and ascites on the CT finding and an elevated level of tumor markers; we also obtained the results of the colonoscopic biopsy that was done via colonoscopy. He was finally diagnosed as having colon cancer with carcinomatosis, a poorly differentiated adenocarcinoma.

• Parasites, Hosts and Diseases
• /
• 제55권5호
• /
• pp.513-521
• /
• 2017

Infectious diarrhea is endemic in most developing countries. We aimed to investigate the protozoan, viral, and bacterial causes of acute diarrhea in Taif, Saudi Arabia. A cross-sectional prospective 1-year study was conducted on 163 diarrheal patients of various ages. Stool samples were collected, 1 per patient, and tested for 3 protozoa, 3 viruses, and 9 bacteria with the Luminex Gastrointestinal Pathogen Panel. Overall, 53.4% (87/163) of samples were positives (20.8% protozoa, 19.6% viruses, 2.8% bacteria, and 9.8% mixed). Rotavirus (19.6%), Giardia duodenalis (16.5%), and Cryptosporidium spp. (8.5%) were the mostly detected pathogens. Adenovirus 40/41 (4.2%), Salmonella (3%), Shiga toxin-producing Escherichia coli (3%), and Entamoeba histolytica (2.4%) were also detected. Norovirus GI/II, Vibrio cholerae, Yersinia enterocolitica, and Clostridium difficile toxin A/B were not detected in any patients. All pathogens were involved in coinfections except E. histolytica. Giardia (5.5%) and rotavirus (3%) were the most commonly detected in co-infections. Enterotoxigenic E. coli (2.4%), Campylobacter spp. (2.4%), E. coli 0157 (1.8%), and Shigella spp. (1.2%) were detected in patients only as co-infections. Infections were more in children 0-4 years, less in adults <40 years, and least >40 years, with statistically significant differences in risk across age groups observed with rotavirus (P<0.001), Giardia (P=0.006), and Cryptosporidium (P=0.036) infections. Lastly, infections were not significantly more in the spring. This report demonstrates the high burden of various enteropathogens in the setting. Further studies are needed to define the impact of these findings on the clinical course of the disease.

• Journal of Microbiology and Biotechnology
• /
• 제28권12호
• /
• pp.2133-2140
• /
• 2018

Norovirus is the most common cause of acute gastroenteritis. Its pathogenesis is poorly understood owing to the difficulty of establishing viral infection in animal models. Here, post-weaning gnotobiotic pigs were infected with human norovirus genogroup II genotype 4 (HuNoV GII.4) to investigate the pathogenesis and replication of the virus. Three groups of four pigs were infected with $1{\times}10^5$, $1{\times}10^6$, or $1{\times}10^7$ genomic equivalent (GE) copies of HuNoV GII.4. Four pigs were used as negative controls. Blood and rectal swab samples were collected after viral infection, and gross legions were examined after necropsy. Diarrhea was induced in 25% and 75% of pigs infected with $1{\times}10^6$ and $1{\times}10^7$ GE copies, respectively. Viral shedding was detected in 50%, 75%, and 50% of pigs infected with $1{\times}10^5$, $1{\times}10^6$, and $1{\times}10^7$ GE copies, respectively. Viremia was detected in 25% of pigs infected with either $1{\times}10^6$ or $1{\times}10^7$ GE copies. When gross lesions of gastroenteritis were investigated, the ileum walls of the infected pigs were thinner than those of the controls. Villi atrophy and inflammatory cell infiltration were identified in the ileum of each infected pig. Viral capsid was identified in the jejunum, ileum, colon, spleen, and mesenteric lymph node. Virus replication was newly verified in the spleen and mesenteric lymph nodes by detection of negative-sense viral RNA. In conclusion, HuNoV GII.4 could induce acute gastroenteritis and replicate in the extra-intestinal lymphoid tissues in post-weaning gnotobiotic pigs. Therefore, such pigs would be a suitable animal model for studying the pathogenesis and replication of HuNoV.

• Journal of Microbiology
• /
• 제44권3호
• /
• pp.327-335
• /
• 2006

An epidemiological survey of human enterobacterial infections was conducted to determine the prevalence of enteropathogens in the Republic of Korea during one year, 2003. We tested for infectious diseases in 26,992 stool samples obtained from people who visited clinics located in six big cities and six rural provinces. From these samples, we isolated 1,291 cases of enteritis bacterial infection (4.8%). In the urban areas, 821 cases of bacterial infection (6.4%) were identified and, in the rural areas, 479 bacterial strains (3.3%) were isolated. Seasonal patterns were seen for diarrhea associated with S. aureus, S. coli and V. parahaemolyticus, while Salmonella and Shigella infections showed slight seasonal variation. We found that S. aureus and Salmonella were more frequently isolated from children and the elderly; however, the prevalence of E. coli, V. parahaemolyticus, and Shigella were similar in different age groups. Routine monitoring of these infections is considered a worthwhile means by which to elucidate their epidemiology and modes of transmission and ultimately to control them more effectively. Continuous laboratory-based surveillance for findings of enteritis bacterial infection should be emphasized in the prevention of these infections.

• 한국임상수의학회지
• /
• 제10권2호
• /
• pp.171-184
• /
• 1993

In Seoul area, there are so many kennel clubs, veterinary hospital, pet establishment and breeding confers that various problems have occurred. They are crowed pet houses, poor sanitation, stress to puppies, sudden environmental changes to puppies and unvaccination against parvovirus, canine distemper virus, parainfluenza virus, infectious hepatitis caused by Adenovirus type I and Leptospira. Several studies were made to survey the infectious agents involved in acute diarrhea of poppies in Seoul are, such as history taking, physical examination, complete blood count and serum chemistry, histopathological finding, bacterial isolation and identification, and hemagglutination test in feces and hemagglutination inhibition test in serum against parvovirus, respectively. The results obtained are summarized as followed. 1. The percent of PCV (30.5$\pm$5.6) and concentration of Total protein(5.0$\pm$0.8) resulted from statistical analysis are significantly lower than normal values (p<0.05), respectively. In addition, fibrinogen (505$\pm$326) was significantly higher an normal value (p<0.001), Band neutrophil (22.9$\pm$12.7) showed signifiant difference (P<0.01). decreased monocyte (3.2$\pm$2.1) and eosinophil (0.7$\pm$0.8) values appeared statistically significant (p<0.001), lymphocyte (16.7$\pm$9), as well. 2. The concentrations of calcium .(8.0$\pm$2.8), glucose (40.1$\pm$31.4), and albumin (2.0$\pm$0.39) were lower than normal values (p<0.01, p<0.01, p<0.001), respectively. Also Inorganic phosphate (7.1$\pm$2.4), pH (p<7.9f:0.2), and Blood Urea Nitrogen (40.41=37.1) were significantly higher than normal values (p<0.001, p(0.001, p<0.05), respectively. 3. Simple and mixed infections occupied 18% and 82% in the distribution of causes in puppies with acute diarrhea, respectively. 4. As puppies got older, incidence of acute diarrhea caused by Staphylococcus aureus was decreased to 13% and infection of canine distemper virus was increased to 53%, but E coli and canine parvovirus always showed high frequency of outbreak in the body weight ranged from 35g to 7.8Kg. 5. As showed in table 5, infections of E coli and Canine Parvovirus showed high outbreak regardless of the age which is classified into three stages, 35~50 day, 60 day and 75~day to 1 year, canine distemper virus appeared increased, but in case of Staphylococcus aureus, visa versa. 6. In comparison wi methods for the laboratory diagnosis diagnosis parvovirus, Hemagglutination test showed positive reaction in 25% and mean serum antibody titer measured by Hemagglutination inhibition test showed 2779 (n=20). In addition, positive reaction was 90% (18/20). 7. In histopathological studies, enteritic and pneumonic lesions were indicated in 53.7% and 39.5% of samples, respectively. 8. Etiologic diagnosis based on the history taking, clinical signs and histopathological findings in puppies with acute diarrhea and vomiting indicated that 50% of puppies were infected by canine parvovirus and distemper virus. 9. In the parasitological examination made by simple flotation with saturated zinc sulfate tour parasites found were Isospora canis, Toxocara canis, Ancylostoma spp and Toxocara spp. Isospora canis and Toxocara canis were more frequently found among those parasites of diarrhoeic causes in puppies ranged from 35 days to 1 year. Their infestation rates were 15% and 13% respectively.

• Pediatric Infection and Vaccine
• /
• 제7권1호
• /
• pp.108-112
• /
• 2000

목 적 : Rotavirus와 adenovirus는 영유아에서 급성장염을 유발하는 주요 원인인데 한국에서 adenovirus에 관한 연구 논문이 적어 저자들은 최근에 발생한 adenovirus와 rotavirus 장염의 분포를 조사하여 향후 질병 예방 및 발생 정보에 도움을 얻고자 연구 분석하였다. 방 법 : 1998년 3월에서 1999년 6월까지 대상으로 건국의대 부속병원에 급성 위장관염으로 입원 또는 통원 치료를 한 143명을 대상으로 하였다. 결 과 : 전체 환아 143명중 rotavirus 양성은 53명으로 37%의 양성률을 보였으며 1999년 1월에서 3월 사이의 초봄에 가장 많이 발생하였으며 2세 이하에서 가장 많이 발생함을 보였고 2~4세 사이에서도 16%의 양성률을 보였으며 9월에 전체 24례중 6례로 가장 많이 검출되었고 2개월에서 2세 사이에 많은 발생을 보였다. Adenovirus와 rotavirus에 동시 검출된 경우는 7명(5%)이였다. 결 론 : Rotavirus 장염은 1월부터 3월에 가장 많은 발생 빈도를 보여서 겨울 및 초봄에 유행시기를 보였으며 adenovirus는 9월에 가장 많이 검출 되었다. Rotavirus와 adenovirus의 발생의 중간 나이 분포는 각각 1세 4개월, 1세 3개월의 분포를 보였다.

• Pediatric Infection and Vaccine
• /
• 제30권2호
• /
• pp.104-110
• /
• 2023

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)는 호흡기계 뿐만 아니라 소화기계에도 감염을 일으킨다. 이중 SARS-CoV-2가 급성 췌장염을 일으키는 경우는 성인과 소아를 포함하여coronavirus disease 2019 (COVID-19) 확진 환자의 약 0.16% 정도이다. COVID-19에 확진된 소아 환자에서의 급성 췌장염은 그 동안 소아다기관염증증후군이나 중증의 코로나 감염 환자에서 동반 질환으로 보고되는 게 대부분이며 단독으로 급성 췌장염만 일으키는 사례는 거의 없었다. 저자들은 SARS-CoV-2에 감염된 소아 환자에게서 단독으로 급성 췌장염이 발생한 예를 경험하였고 성공적으로 치료하였기에 보고하는 바이다.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제13권1호
• /
• pp.30-35
• /
• 2010

목 적: 감염성 회장맹장염은 회장맹장 부위에 국한된 감염으로 소아 복통의 가장 흔한 원인 중 하나이다. 대부분 증상이 심각하지 않고 수 일 내에 자연 회복되지만 다양한 원인에 의해 발생하고 원인체 규명이 쉽지 않아 이 질환에 대한 보고가 드물다. 방 법: 2004년 1월부터 2008년 7월까지 설사나 발열을 동반하거나 동반하지 않는 우하복부 복통으로 부산 대학교병원을 방문한 환자 중 복부 초음파 검사 또는 CT 촬영에서 회장 말단부나 맹장에 장벽 비후를 보여 회장염 또는 회장결장염으로 진단된 37명(남 26명, 여 11명)을 대상으로 하였다. 임상적 및 방사선학적 소견에 대해 의무기록을 후향적으로 분석하였다. 만성 염증성 장질환, 급성 충수돌기염의 천공이나 결핵성 복막염등에 의한 2차적인 회장맹장염과 호중구 감소성 소장대장염, 로타바이러스를 포함한 바이러스 장염은 제외하였다. 결 과: 1) 남자가 27명(73.0%), 여자가 10명(27.0%)이었다. 진단 시 평균 연령은 4.8${\pm}$3.4세로 환자의 절반이 학동전기 아동이었다. 2) 주소는 복통 28명(75.7%), 구토 3명(8.1%), 설사 4명(10.8%)이었다. 3) 동반 증상으로는 발열 21명(56.8%), 구토 8명(21.6%), 설사 6명 (16.2%), 혈변 1명(2.7%)이었다. 4) 증상의 지속 기간은 복통 3.8${\pm}$2.1일, 발열 3.0${\pm}$1.9일, 설사 3.4${\pm}$1.9일, 구토 2.4${\pm}$2.3일이었다. 유병 기간은 7.5${\pm}$5.0일이었다. 5) 설사는 하루 5.8${\pm}$2.2회, 구토는 하루 4.0${\pm}$2.8회의 빈도를 보였다. 6) 진단 방법은 복부 초음파 검사 22명(59.5%), CT 촬영 2명(5.4%), 복부 초음파 및 CT 촬영 13명 (35.1%)이었다. 7) 동반된 영상 소견으로는 장간막 림프절염 22명(59.5%), 복수 2명(5.4%), 림프절염과 복수가 모두 동반된 경우가 6명(16.2%)이었다. 8) 초기 추정진단은 급성 위장관염 15명(40.5%), 장간막 림프절염 9명(24.3%), 장중첩증 5명(13.5%), 급성 충수돌기염 및 감염성 대장염 각 2명(5.4%)이었다. 9) 특이 검사 소견이 없었으며 원인 규명을 위한 검사에서 모두 음성이었다. 10) 모든 환자에서 대증 치료로 자연 회복되었다. 결 론: 감염성 회장맹장염은 급성 충수돌기염과의 유사한 임상 소견을 보이나 단기간 내 자연 회복되기 때문에 불필요한 검사나 치료를 피해야 한다. 그러나 급성 충수돌기염에 의한 이차적인 회장맹장염과 만성염증성 장질환, 일차성 장간막 림프절염 등의 질환과 감별이 필요하다.

• Pediatric Infection and Vaccine
• /
• 제14권1호
• /
• pp.111-115
• /
• 2007

본 저자들은 발열과 점액성 혈변을 보인 신생아에서 대변 현미경 검사를 통해 이질아메바를 진단하고 metronidazole 경구 투약 후 증상의 호전과 이질아메바의 제거를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 한국환경보건학회지
• /
• 제48권3호
• /
• pp.176-182
• /
• 2022

Background: The risk of imported infectious diseases has been increasing with the annual rise in the number of international travelers. Objectives: This study aims to analyze the distribution and characteristics of intestinal bacteria isolated in 2019 from residents of Chungcheongnam-do Province with experience of travelling overseas. Methods: Twenty-three former overseas travelers with diarrhea were analyzed to detect viruses and bacteria according to the Manual for Detection of Foodborne Pathogens at Outbreaks. Additionally, antibiotic susceptibility tests and 16s rRNA sequencing were performed. Results: Twenty-five strains of ten pathogens were isolated from 18 samples. Pathogenic E. coli was the most common at 57.7%, followed by Clostridium perfringens (15.4%), Campylobacter spp. (7.7%), and Salmonella spp. (7.7%). The serotype of Salmonella was confirmed as Salmonella Braenderup, II 9,46:g,[m],[s],t:[e,n,x]. Conclusions: It was confirmed that the major enteric bacterial pathogens isolated from overseas travelers in Chungcheongnam-do Province were pathogenic E. coli, as found in other studies. The study on Plesiomonas shigelloides is meaningful in that it is reported as a rare case of infection in Korea. Antibiotic resistance and 16s rRNA analysis were performed, which is expected to provide important basic data for the prevention of traveler's diarrhea.