• Tuberculosis and Respiratory Diseases
• /
• v.70 no.2
• /
• pp.125-131
• /
• 2011

Background: The clinical manifestation of $M.$ $tuberculosis$ infection ranges from asymptomatic latent infection, to focal forms with minimal symptoms and low bacterial burdens, and finally to advanced tuberculosis (TB) with severe symptoms and high bacillary loads. We investigated the diagnostic sensitivity of the whole-blood interferon-${\gamma}$ release assay according to the wide spectrum of clinical phenotypes. Methods: In patients diagnosed with active TB that underwent $QuantiFERON^{(R)}$ (QFT) testing, the QFT results were compared with patients known to be infected with pulmonary tuberculosis (P-TB) and extra-pulmonary TB (EP-TB). In addition, the results of the QFT test were further analyzed according to the radiographic extent of disease in patients with P-TB and the location of disease in patients with EP-TB. Results: There were no statistical differences in the overall distribution of QFT results between 177 patients with P-TB and 84 patients with EP-TB; the positive results of QFT test in patients with P-TB and EP-TB were 70.1% and 64.3%, respectively. Among patients with P-TB, patients with mild extents of disease showed higher frequency of positive results of QFT test than that of patients with severe form (75.2% vs. 57.1%, respectively; p=0.043) mainly due to an increase of indeterminate results in severe P-TB. Patients with TB pleurisy showed lower sensitivity by the QFT test than those with tuberculous lymphadenitis (48.8% vs. 78.8%, respectively; p=0.019). Conclusion: Although QFT test showed similar results between overall patients with P-TB and EP-TB, individual sensitivity was different according to the radiographic extent of disease in P-TB and the location of disease in EP-TB.

• Korean Journal of Veterinary Research
• /
• v.32 no.1
• /
• pp.117-125
• /
• 1992

Dogs were divided into 3 groups of two each; Bacillie Calmette-Guerin(BCG) pretreatment, M bovis only treatment and uninfected control group. BCG were vaccinated intradermally with 0.2ml before 3weeks of M bovis intraperitoneal infection. Infection at necropsy 4months later was readily in the both treated dogs. Histopathologically, the BCG pretreated dogs produce the moderate accumulation of macrophages and focal granuloma formation in the lung, whereas the M bovis only treared dogs produce the accumulation of predominantly macrophages, occasionaly polymorphonuclear cells and the more larger granuloma Bronchoalveolar lavage(BAL) was obtained and total and differential cell counts were examined. Total number of BAL cells harvested from uninfected dogs is lower compared with those of the both treated groups. The total cell number of M bovis only treated dogs were singificantly higher 1.8 times than that of the BCG pretreated dogs. The Fe receptor activity and the growth of organism in alveolar macrophages obtained from BCG pretreated dogs were compared with that in macrophages from M bovis only treated dogs. BCG vaccination resulted in substantial macrophage activation, measured as increased Fc receptor mediated phagocytosis and rosette formation, as wells as the inhibition of intracellular mycobacteria multiplication. However, actibated macrophages taken from BCG pretreated dogs are incapable of killing the M bovis. Thus, these results suggest that BCG pretrearment in the dog may produce a protective effect against tuberculosis because active alveolar macrophages have acquired antituberculous immunity, although few mycobacteria within the lung remain in a metabolically active state.

• Parasites, Hosts and Diseases
• /
• v.58 no.6
• /
• pp.627-634
• /
• 2020

Belitung district in Bangka-Belitung Province, Indonesia with a population of 0.27 million is endemic for Brugia malayi and 5 rounds of mass drug administration (MDA) were completed by 2010. Based on the results of 3 transmission assessment surveys (TAS), the district is declared as achieving elimination of lymphatic filariasis (LF) in 2017. The findings of an independent survey conducted by the National Institute of Health Research and Development (NIHRD) in the same year showed microfilaria (Mf) prevalence of 1.3% in this district. In 2019, NIHRD conducted microfilaria survey in 2 villages in Belitung district. Screening of 311 and 360 individuals in Lasar and Suak Gual villages showed Mf prevalence of 5.1% and 2.2% with mean Mf density of 120 and 354 mf/ml in the respective villages. Mf prevalence was significantly higher among farmers and fishermen compared to others and the gender specific difference was not significant. The results of a questionnaire based interview showed that 62.4% of the respondents reported to have participated in MDA in Lasar while it was 57.7% in Suak Gual village. About 42% of the Mf positive cases did not participate in MDA. Environmental surveys identified many swampy areas supporting the breeding of Mansonia vector species. Persistence of infection is evident and in the event of successful TAS3 it is necessary to monitor the situation and plan for focal MDA. Appropriate surveillance strategies including xenomonitoring in post-MDA situations need to be developed to prevent resurgence of infection. Possible role of animal reservoirs is discussed.

• Pediatric Infection and Vaccine
• /
• v.10 no.2
• /
• pp.215-222
• /
• 2003

Purpose : This study was to analyze serious bacterial infections in infants younger than three months of age and to review the direction of treatments for these patients. Methods : 378 febrile infants with a rectal temperature ${\geq}38.0^{\circ}C$ visited from Jan. 2001 through Dec. 2002 were retrospectively studied. Infants with the following criteria belonged to the low risk group. WBC $5,000{\sim}15,000/mm^3$, WBC negative in urine stick test and negative for nitirite test, CSF WBC < $10/mm^3$ and negative in CSF gram stain, negative chest X-ray, stool WBC <5/HFP(high power field), and focal infection. If any of the above criteria were not met, they belonged to the high risk group. SBI was defined as a positive culture of urine, blood or CSF. SI was defined as aseptic meningitis or pneumonia including above laboratory tests of SBI. SBI patients were separately compared with two groups, high risk and low risk. Results : Of the 378 infants that were tested 216(57.1%) were in the high risk group and 162(42.9%) in the low risk group. Among 105 SBI(27.8%) and 172 SI(45.5%), there were 98 urinary tract infection(25.2%), 10 bacteremia(2.6%), 2 bacterial meningitis(0.6%), and 77 aseptic meningitis(22.8%). There were 76 SBI(35.2%) from the high risk group and 29 SBI(17.9%) from the low risk group identified. The results of the sensitivity(72.4%), the specificity(48.7%), the negative predictive value(82.1%) and the positive predictive value (35.2%) were calculated. Conclusion : Even though the probability of SBI in the low risk group is insignificant, it should still be considered in febrile infants younger than 3 months of age. I believe the CSF study is necessary because of the moderate high incidence of abnormal finding in our study.

• Pediatric Infection and Vaccine
• /
• v.12 no.2
• /
• pp.140-148
• /
• 2005

Purpose : To characterize the epidemiology and clinical features of invasive pneumococcal infections in Korean children. Methods : One hundred ninety four cases of invasive pneumococcal infections diagnosed at the Seoul National University Children's Hospital from October 1985 to December 2003 were analysed retrospectively. All isolates were screened for resistance to penicillin by oxacillin disc diffusion test. Serotypes were determined for 125 isolates. Results : The types of infection were bacteremia without focus 84/194(43%), meningitis 36/194(19%), pneumonia with bacteremia 36/194(19%), peritonitis 24/194(12%), other focal infections 3/194(2%). Fifty seven percent(110/194) of the episodes developed in the immunocompromised and 20%(37/194) were nosocomially acquired. The patients younger than 2 years of age was 60% in the immunocompetent patients and 25% in the immunocompromised patients. The overall case fatality rate was 7%. All the isolates by 1988 were susceptible to penicillin screened by oxacillin disk. Penicillin resistance was first detected in 1989(20%), and then increased rapidly; 89% in 1995, 69% in 1996, and 80~100% thereafter. The seven most frequently isolated serotypes were 23F, 19F, 14, 6B, 6A, 9V and 19A, which accounted for 70% of total isolates. Conclusion : S. pneumoniaeis an important cause of morbidity and mortality in children. Invasive infections caused by S. pneumoniae most often occurred in infants and young children, while they are frequent in older immunocompromised children as well. This is the largest case series on invasive pneumococcal infections in Korean children.

• Tuberculosis and Respiratory Diseases
• /
• v.67 no.1
• /
• pp.37-41
• /
• 2009

Lymphocytic interstitial pneumonia (LIP) is a rare disorder characterized by a diffuse infiltration of the alveolar space, interstitium by lymphocytes, plasma cells, and reticuloendothelial cells. Although its etiology is unknown, LIP has been associated with autoimmune disorders and with viral infections. Because it's clinical and radiographic features are nonspecific, a confirmatory diagnosis is performed by open lung biopsy. A 59-year-old female presented dry cough, which had been present for 1 month. On initial findings of multifocal consolidation at the right middle lobe on both lower lobes in chest radiography, the first diagnosis of cryptogenic organizing pneumonia was suggested. On open lung biopsy, LIP was diagnosed. The patient had no autoimmune disease, viral infection or monoclonal gammopathy. After 3 months of corticosteroid treatment, the patient experienced improved symptoms, reduced abnormalities on chest radiography, and improved pulmonary function testing.

• Archives of Plastic Surgery
• /
• v.37 no.4
• /
• pp.469-472
• /
• 2010

Purpose: Aplasia Cutis Congenita (ACC) is a rare disease characterized by the focal defect of the skin at birth, frequently involving scalp, but it may affect any region of the body. There are no etiology known but some conditions such as intrauterine vascular ischemia, amniotic adherences and viral infections are associated. The ideal treatment for the ACC is not known. Superficial and relatively small sized defects (< $3{\times}5\;cm$) may heal spontaneously and large defects related with risks of infection and bleeding may require aggressive surgical treatment. Hyalomatrix$^{(R)}$ is a bilayer of an esterified hyaluronan scaffold beneath a silicone membrane. It has been used as a temporary dermal substitute to cover deep thickness skin defect and has physiological functions derive from the structural role in extracellular matrix and interaction with cell surface receptor. This material has been used for the wound bed pre-treatment for skin graft to follow and especially in uncooperative patient, like a newborn, this could be a efficient and aseptic way of promoting granulation without daily irritative wound care. For this reason, using Hyalomatrix$^{(R)}$ for the treatment of ACC was preferred in this paper. Methods: We report a case of a newborn with ACC of the vertex scalp and non-ossified partial skull defect. The large sized skin and skull defect ($6{\times}6\;cm$) was found with intact dura mater. No other complications such as bleeding or abnormal neurologic sign were accompanied. Escharectomy was performed and Hyalomatrix$^{(R)}$ was applied for the protection and the induction of acute wound healing for 3 months before the split-thickness skin graft. During the 3 months period, the dressing was renewed in aseptic technique for every 3 weeks. The skin graft was achieved on the healthy granulation bed. Results: The operative procedure was uneventful without necessity of blood transfusion. Postoperative physical examination revealed no additional abnormalities. Regular wound management was performed in out-patient clinic and the grafted skin was taken completely. No other problems developed during follow-up. Conclusion: Hyalomatrix$^{(R)}$ provides protective and favorable environment for wound healing. The combination of the use of Hyalomatrix$^{(R)}$ and the skin graft will be a good alternative for the ACC patients with relatively large defect on vertex.

• Journal of Veterinary Clinics
• /
• v.30 no.2
• /
• pp.115-118
• /
• 2013

An 8-year-old spayed female domestic shorthair cat was presented with a chief complaint of chronic nasal discharge and dyspnea. Physical examination revealed pyohemorrhagic nasal discharge, inspiratory dyspnea and stertor, and an enlarged right mandibular lymph node. Abnormalities of blood works and serum chemistry included mildly increased hematocrit, and globulin concentration. Serologic tests for FeLV and FIV, and a panel of polymerase chain reaction tests for Chlamydophila felis, Feline Calicivirus, Herpesvirus, Bordetella, Mycoplasma felis, and H1N1 influenza was all negative. Only radiographic finding showed increasing soft tissue density in the right nasal cavity and computed tomography disclosed soft tissue/fluid opacification in the right nasal cavity, paranasal sinus, and pharyinx along with slight deviation to the right of the osseous nasal septum. Focal lysis of ventral nasal septum was also suspected in CT scan. Cytological evaluation of fine needle aspirate smears of the enlarged mandibular lymph nodes revealed numerous fungal yeasts having variably thick capsule both extracellularly and intracellularly with low numbers of macrophages. Some yeasts showed narrow based budding, which was a consistent finding with Cryptococcus organisms. Serum protein electrophoresis was a polyclonal consistent with chronic infection and serum was submitted for a fungal serology panel test. In serologic tests Cryptococcus antigen titer was 1 : 32,768. In vitro culture was unsuccessful. Treatment was initiated with administration of fluconazole, clindamycin, and tocopherol. Clinical signs resolved within 3 days after the initial treatment. The cat was discharged and scheduled for periodic evaluation and continued therapy, but was lost to follow-up thereafter.

• Journal of Practical Agriculture & Fisheries Research
• /
• v.22 no.2
• /
• pp.51-58
• /
• 2020

Continuous mortality in commercially cultured Japanese eel (Anguilla japonica), showing symptoms of dermal ulcerations and focal hemorrhages on the body, occurred on a private farm in November, 2019 in Korea. A series of mortality had been described in one local eel culture farm from November to December in 2019. From the three cases, three isolates of Vibrio spp. were recovered from the blood, ascitic fluid, and kidney of the dead fish, respectively. Based on the 16S rRNA sequence comparisons, the Vibrio isolates from the 1^st and 3^rd cases (strain named 1E1-2 and 3K1-2) were identified as V. fluvialis and the isolate from the 2^nd case was identified as V. plantisponsor (strain named 2A3-1). Moreover, the 16S rRNA-based phylogenetic analysis revealed that strain 1E1-2 and 3K1-2 were most similar to V. fluvialis NBRC 103150^T, and strain 2A3-1 was most similar to V. plantisponsor NBRC103148^T. According to the results of the antibiotic resistance determination, V. fluvialis 1E1-2 showed intermediate resistance to tetracycline and chloramphenicol, and was resistant to trimethoprim-sulfamethoxazole. V. plantisponsor 2A3-1 showed intermediate resistance to ciprofloxacin and levofloxacin, and was resistant to trimethoprim-sulfamethoxazole. V. fluvialis 3K1-2 showed intermediate resistance to tetracycline, and was resistant to ampicillin and trimethoprim-sulfamethoxazole. These results have provided the evidences on the occurrence of antibiotic-resistant Vibrio infection in commercially cultured Japanese eels are present in Korea.

• Childhood Kidney Diseases
• /
• v.5 no.1
• /
• pp.22-29
• /
• 2001

Purpose : 99mTc DMSA renal scan have been widely used not only for tile evaluation of renal scars but also for the diagnosis of acute pyelonephritis. Recent studies have shown SPECT images have higher accuracy than the planar images with some controversy. We evaluated the availability of the SPECT images adding to planar images for the diagnosis of acute pyelonephritis(APN) and renal scar in children with urinary tract infection (UTI). Methods : 130 children with UTI (260 kidney units) and 22 follow-up children (44 kidney units) were included between January 1, 1997 and July 31, 1999 at Ewha University Mokdong Hospital. Planar Anterior and posterior images and SPECT axial and coronal images of 99mTc DMSA renal scan were obtained with Starcam 4000-i U.S.A. GE at 3 hours after 99mTc DMSA I.V. injection. The data were analyzed by Chi square test after Yates's correction. Results : The detection rate of the acute pyelonephritis by SPECT images was 12.3$\%$ higher than that of planar images ($47.7\%\;vs\;35.4\%$) by the patient and 6.9$\%$ higher also ($31.9\%\;vs\;25.4\%$) by the kidney unit. 18 kidney units with negative planar images had focal defect in 10 kidney units (3.8$\%$) and multifocal defect in 8 kidney units (3.1$\%$) on SPECT images, but 1 kidney unit with positive planar image had negative SPECT image. SPECT images were superior to tile planar images in 17.3$\%$. identical in 82.3$\%$ and inferior in 0.4$\%$ to planar image. The detection rate of tile renal scars by SPECT images was 13.7$\%$ higher than planar images by the patient ($68.2\%\;vs\;54.5\%$) and 6.8$\%$ higher also ($43.2\%\;vs\;36.4\%$) by the kidney unit. SPECT images were superior to the planar images in 17.3$\%$ and identical in 82.3$\%$ to planar image. Conclusion SPECT images had shown higher detection rate and better image than planar images for the diagnosis of the acute pyelonephritis and the evaluation of the renal scars. (J. Korean Soc Pediatr Nephrol 5 : 22- 9, 2001)