Escherichia coli is recovered from a wide variety of infections in many animals species. It may be a primary or secondary agent. Nursing and young animals are particularly susceptible, and urinary tract infections are frequent. The various serotypes of E coli are intestinal inhabitants of animals including humans and probably infect most mammals and birds : therefore, they have a cosmopolitan distribution. Colibacillosis refers to any totalized or systemic infection caused entirely or partly by E coli. Collibacillosis in mammals is most often a primary enteric disease, whereas collibacillosis in poultry is typically a secondary located or systemic disease occurring when host defenses have been impaired or overwhelmed. Other opportunistic bacteria, which can be identified by culture, may play a similar role to that of I coli in secondary infections. Collectively, infections caused by E coli are responsible for significant economic losses to the animal performance. From the standpoint of pathogenic mechanisms and diseases, four major categories of E coli are recognized : enterotoxigenic(ETEC), enteropathogenic (EPEC), enteroinvasive(EIEC), and enterohemorrhagic(EHEC). In addition, two less-well-defined E coli categories are recognized in animals and humans : enteroaggregative and cytotoxin necrotizing factor-positive. The aforementioned categories are represented by different serotypes. Certain serotypes show a host preference and are encountered more frequently in some disease syndromes. Of the four major categories, ETEC is the most common cause of diarrhea in calves, lambs, and pigs. Strains in the other categories cause the less-common diarrhea and other disease syndromes. Enterotoxins and pilus antigens are the two most prominent virulence factors thus far identified for ETEC. Two enterotoxins, one heat-stable(ST) and one heat-labile(LT), are produced by enterotoxigenic strains of E coli : not all culture produce both of these plasmid-based enterotoxins.
Jeong, Kyung Min;Lee, Cheong Hoon;Kim, Su Hyun;Lee, Jeongmi
Analytical Science and Technology
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v.30
no.1
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pp.39-48
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2017
Roxithromycin (RXT), which is an antibiotic used to treat respiratory tract and urinary infections, is official in Korean Pharmacopoeia (KP) and is marketed in various dosage forms including tablet, granule, suspension, and tablet for suspension in Korea. This study presents how a universal and reliable method to quantify RXT in bulk drug and formulations was developed. Effects of factors including column type, buffer concentration, type and concentration of organic solvent, buffer pH, and type and concentration of mobile phase additive, were examined, and some categorical or crucial factors including the types of column, organic solvent, mobile phase additive and the buffer pH were optimized by one-factor-at-a-time approach. Subsequently, concentrations of the buffer and additive and column temperature were optimized by response surface methodology using Box-Behnken design aiming to acquire the RXT peak of good shape. The optimized method employed a Phenomenex Gemini $5{\mu}$ C18 110A ($150{\times}4.60mm$, $5{\mu}m$) maintained at $30^{\circ}C$ with the mobile phase consisting of 25 mM phosphate buffer (pH 6.0) with 0.3 % tetrabutylammonium hydroxide and methanol at a ratio of 37:63 (v/v). Method validation results showed that the developed method was linear, precise, and accurate. Compared to the compendial methods in KP 10 that exhibited a significant tailing of the RXT peak despite using unfavorably high buffer concentrations and were not harmonized among bulk drug and formulations, this method could be universally applied to RXT bulk drug and marketed products in various dosage forms and thus was adopted in KP 11.
Background : Surgical site infection(SSI) is one of the important nosocomial infections with pneumonia, urinary tract infection. SSI increases mortality, morbidity, length of stay, and costs for postoperative patients. The purpose of this study was to estimate length of stay(LOS) and health care costs from SSI using the large observational data. The ultimate objective was to show the effect of prevention of SSI. Method : This study used antibiotic prophylaxis evaluation data and claims data of the HIRA(Health Insurance Review and Assessment Service). The study population included 18,361 patients who underwent gastric surgery, endoscopic cholecystectomy, colon surgery, hysterectomy, cesarean section in nationwide hospitals from August to October 2007. SSI group and non-SSI group were matched according to propensity score resulted from logistic regression. The paired t-test was used to compare the difference of the LOS and health care costs between SSI group and non-SSI group. Results : The 598 cases of SSI were detected of total subjects, and the crude SSI rate was 3.3%. For each surgery, SSI rates were 5.5% for gastric surgery, 4.7% for cholecystectomy, 6.6% for colon surgery, 2.6% for hysterectomy, and 1.6% for cesarean section. The 596 cases of SSI and the 596 cases of non-SSI were matched by propensity score. The LOS of SSI group was longer than that of non-SSI group, and the difference was statistically significant. Health care costs of SSI group was more than that of non-SSI group which was significant. Conclusions : SSI increased apparently the LOS and healthcare costs. The economic loss might affect the cost of national healthcare as well as patients and hospitals. This study provided the evidence that the healthcare expenditure could be reduced by preventing SSI.
Clinical observation was done on 272 cases of patients who were diagnosed as CVA with brain CT, TCD, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from 1st January to 31st December in 1997. 1. The cases were classified into the following kinds: cerebral infarction, cerebral hemorrhage. and transient ischemic attack. The most case of them was the cerebral infarction. 2. There is no significant difference in the frequency of strokes in male and female. And the frequency of strokes was highest in the aged over 50. 3. In cerebral infarction the most frequent lesion was the territory of middle cerebral artery, and in cerebral hemorrhage the most frequent lesion was the basal ganglia. 4. The most ordinary preceding disease was hypertension. and the next was diabetes. 5. The rate of recurrence was high in cerebral infarction. 6. The cerebral infarction occurred usually in resting and sleeping, and the cerebral hemorrhage in acting. 7. The common symptoms were motor disability and verbal disturbance. 8 The average time to start physical therapy was 1l.3rd day after stroke in cerebral infarction and it was 15.2th day after stroke in cerebral hemorrhage. 9. The common complications were urinary tract infection, pneumonia, myocardial infarction. 10. Hypercholesterolemia and hypertriglyceridemia are usually found more frequently in cerebral infarction than in hemorrhage. 11. In acute or subacute stage, the methods of smoothening the flow of ki(順氣), dispelling phlegm(祛痰), clearing away heat(淸熱) or purgation(瀉下) were frequently used. and in recovering stage, the methods of replenishing ki(補氣), tonifying the blood(補血) or tranquilization(安神) were frequently used.
Alfuzosin, an Alphal-adrenoceptor antagonist is used for the treatment of patients with voiding and in a lesser extent storage lower urinary tract symptoms (LUTS) associated to benign prostatic hyperplasia (BPH). The objective of this study was to formulate sustained release alfuzosin HCl granules and assess their formulation variables. The $Eudragit^{(R)}$ as a polymer, sustained release membrane, and dibutyl sebacate (DBS) as a plasticizer were used. Multi-coated alfuzosin HCl delivery systems composed of sugar sphere, various excipients, $Eudragit^{(R)}$ and HPMC (hydroxy propyl methyl cellulose), Cellulose Acetate were prepared by fluid-bed coater. Membrane layer were used $Eudragit^{(R)}$ RS PO and NE 30D. And the alfuzosin HCl coated beads were coated immediate release drug layer for initial burst. Its dissolution test was carried out compared to conventional products ($XATRAL^{(R)}$ XL). The release rate of drug from coated beads was higher than that from $XATRAL^{(R)}$ XL in pH 6.8.
Fluoroquinolone (FQ) resistant uropathogenic Escherichia coli (UPEC) have become a major problem in urinary tract infections (UTIs). The purpose of this study was to compare the quinolone resistance-determining region (QRDR) and plasmid mediated quinolone resistance (PMQR) determinants of FQ resistant UPEC between 1989 and 2010-2014. A total of 681 strains of UPEC clinical isolates was collected from Korean healthcare facility in 1989 (123 strains) and in 2010-2014 (558 strains). The minimum inhibitory concentrations (MICs) of FQs were determined by agar dilution method. QRDRs (gyrA, gyrB, parC and parE) and PMQR determinants (qnrA, qnrB, qnrS, aac(6')-Ib-cr and qepA) were analyzed polymerase chain reaction and sequencing method. Among 681 isolates, FQ resistant UPEC were 3 strains (2.4%) in 1989 isolates and 220 strains (39.4%) in 2010-2014 isolates. The rate of the FQ resistant UPEC strains in 2010-2014 isolates was increased than that of in 1989 isolates. UPEC isolates from 1989 and 2010-2014 were shown to carry mutations in gyrA (Ser83 and Asp87), gyrB (Ser464 and Thr469), parC (Ser80 and Glu84) and parE (Glu460, Ser458, Ile464 and Leu445). The most common mutations of QRDRs in 1989 isolates were Ser83Leu and Asp87Gly in gyrA and Ser80Ile in parC (2 strains: 66.7%) while those in 2010-2014 isolates were Ser83Leu and Asp87Asn in gyrA and Ser80Il2 and Glu84Val in parC (88 strains: 40.0%). PMQR determinants were detected only in 2010-2014 UPEC strains (47 strains: 21.4%).
Hypospadias is a malformation in which the urethra open on the ventral side of the penis and its frequency is about from 0.3% to 0.5% male birth in human. It is considered a disorder both genetic and environmental factors involves in pathogenesis. A KNC(Korean native calf) showing symptoms of fusion defect of the male ventral urethra, penile defect, bifid scrotum and low body weigh was born. To prevent an ascending urinary tract infection, dermatitis and loss of hair, surgical operation was performed to make a genitals like a female. After the operation, the KNC got a regenerative hair and normal urination. However the KNC became anorexia, loss in weight and weak. Seventy days after birth, the KNC died. The view of autopsy was a yellowish hepatomegaly, hydronephrosis, closed ureter and complex disorder in interanl organ. The symptoms of hepatomegaly and hydronephrosis could be due to a fluid therapy as a consequence of ureter obstruction. The normal urination of the KNC before it got sick, suggested that ureter obstruction in the case of this KNC was formed at its postnatal growth stage.
Vaginal tumors are the second most common types of tumor in canine female reproductive tract, and most of these tumor are diagnosed as leiomyoma. These tumors are categorized by intraluminal or extraluminal form, and tend to develop as hormone dependent manner. In this report, we describe two cases of extra-luminal form of vaginal tumor. Both tumors were located in abdominal cavity, and adhered to entire surrounding internal organs, including urinary bladder, rectum, and particularly a part of ureter. Surgical excision was performed via laparotomy without damage to the surrounding internal organs and ovariohysterectomy, as well. A diagnosis of vaginal leiomyoma was established based on histopathology.
A 33-year-old woman visited the emergency department presenting with fever and dyspnea. She was pregnant with gestational age of 31 weeks and 6 days. She had dysuria for 7 days, and fever and dyspnea for 1 day. The vital signs were as follows: blood pressure 110/70 mmHg, heart rate 118 beats/minute, respiratory rate 28/minute, body temperature $38.7^{\circ}C$, and oxygen saturation by pulse oximetry 84% during inhalation of 5 liters of oxygen by nasal prongs. Crackles were heard over both lung fields. There were no signs of uterine contractions. Chest X-ray and chest computed tomography scan showed multiple consolidations and air bronchograms in both lungs. According to urinalysis, there was pyuria and microscopic hematuria. She was diagnosed with community-acquired pneumonia and urinary tract infection (UTI) that progressed to severe sepsis and acute respiratory failure. We found extended-spectrum beta-lactamase producing Escherichia coli in the blood culture and methicillin-resistant Staphylococcus aureus in the sputum culture. The patient was transferred to the intensive care unit with administration of antibiotics and supplementation of high-flow oxygen. On hospital day 2, hypoxemia was aggravated. She underwent endotracheal intubation and mechanical ventilation. After 3 hours, fetal distress was suspected. Under 100% fraction of inspired oxygen, her oxygen partial pressure was 87 mmHg in the arterial blood. She developed acute kidney injury and thrombocytopenia. We diagnosed her with multi-organ failure due to severe sepsis. After an emergent cesarean section, pneumonia, UTI, and other organ failures gradually recovered. The patient and baby were discharged soon thereafter.
Rongviriyapanich, Chantima;Sakunchit, Thanarat;Sudla, Chirawat;Mungkung, Supamas;Pongnapang, Napapong;Yeong, Chai Hong
Clinical and Experimental Pediatrics
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v.63
no.12
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pp.491-498
/
2020
Background: Renal size is an important indicator in the diagnosis of renal diseases and urinary tract infections in children. Purpose: The purpose of this study is twofold. First, it aimed to measure the renal length and calculate the renal volume of normal Thai children using 2-dimensional ultrasonography (2D-US) and study their correlations with somatic parameters. Second, it aimed to compare the age-specific renal size of normal Thai children with the published data of their Western and Chinese counterparts. Methods: A total of 321 children (150 boys, 171 girls; age, 6-15 years) with a normal renal profile were prospectively recruited. All subjects underwent 2D-US by an experienced pediatric radiologist and the renal length, width, and depth were measured. Renal volume was calculated using the ellipsoid formula as recommended. The data were compared between the left and right kidneys, the sexes, and various somatic parameters. The age-specific renal lengths were compared using a nomogram derived from a Western cohort that is currently referred by many Thailand hospitals, while the renal volumes were compared with the published data of a Chinese cohort. Results: No statistically significant difference (P<0.05) was found between sexes or the right and left kidneys. The renal sizes had strong correlations with height, weight, body surface area, and age but not with body mass index. The renal length of the Thai children was moderately correlated (r=0.59) with that of the Western cohort, while the age-specific renal volume was significantly smaller (P<0.05) than that of the Chinese children. Conclusion: Therefore, we concluded that the age-specific renal length and volume obtained by 2D-US would vary between children in different regions and may not be suitably used as an international standard for diagnosis, although further studies may be needed to confirm our findings.
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