• Korean Journal of Veterinary Research
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• v.33 no.2
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• pp.301-308
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• 1993

Three or 7day old piglets were infected experimentally with different encephalomyocarditis virus isolates to detect the viral antigen by the immunoperoxidase technique and to observe strain difference in their pathogenecity in newborn pigs by comparing clinical signs and pathologic lesions. Clinical signs of the infected pigs were different depending on the virus strain, pig age and infection route. Encephalomyocarditis virus(EMCV) NVSL-PR isolate was more pathogenic than MN-25 and MN-30 isolate. Three day old piglets showed more severe illness than 7 day old piglets. Predominant clinical signs were sudden death without noticeable clinical signs and dyspnea manifested as heavy abdominal breathing. Contact-infection from infected piglets to controls was observed in the oro-nasally infected group but not the intramuscular group. Common necropsy findings of dead piglets in both age groups infected with MN-25 and NVSL-PR were accumulation of excessive fluid in the body cavities and mild to diffuse necrotic areas observed in the hearts and occasionally in the livers. Microscopically, myocarditis with inflammatory cell infiltration, necrosis of the myocardial muscle fibers and occasional mineralization were observed along with interstitial pneumonia and centrolobular necrosis in the liver. Using an immunoperoxidase technique, viral antigen was detected in myocardial muscle fibers of piglets infected with EMCV.

• Journal of Yeungnam Medical Science
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• v.40 no.2
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• pp.193-197
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• 2023

Klebsiella pneumoniae is an uncommon cause of septic arthritis in adults. However, late detection can cause serious complications, including joint destruction and immobility. The purpose of this study was to report a case of successfully treated septic arthritis of the hip joint (SAHJ) caused by K. pneumoniae. A 49-year-old female patient presented to our hospital with fever and progressive severe pain in the right hip area. Although there was no abnormality on plain radiographs, ultrasonography revealed diffuse swelling of the right hip joint. Under ultrasonography guidance, the hip joint fluid was aspirated, and Gram staining and culturing were performed. The patient's pain was significantly reduced after the joint aspiration. The Gram staining and culturing revealed gram-negative bacilli, which were subsequently identified as K. pneumoniae. According to the results, systemic intravenous antibiotic (ceftriaxone) was administered without complications, and the patient was discharged on oral antibiotic (ciprofloxacin). Clinical cases of septic arthritis of the knee or sacroiliac joint have been occasionally reported in adults, but cases of SAHJ are rare. Moreover, K. pneumonia-induced SAHJ has not been reported to date. Therefore, we report this very rare case and its successful treatment.

• Korean Journal of Veterinary Service
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• v.34 no.4
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• pp.313-320
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• 2011

The purpose of this study was to investigate association with gross lesions and causative pathogens of porcine respiratory disease complex (PRDC) including porcine circovirus type 2 (PCV2), porcine reproductive and respiratory syndrome virus (PRRSV), swine influenza virus (SIV), Mycoplasma hyopneumoniae (MH), Pasteurella multocida (PM), Actinobacillus pleuropneumoniae (APP), Haemophilus parasuis (HP) in slaughtered pigs. A total of 1,200 lung samples were collected randomly from slaughtered pigs in Korea during August of 2010 through July of 2011. The gross lesions were classified according to the six stages (0, 1~10, 11~20, 21~30, 31~40 and ${\geq}41$, unit=%) and 48 samples from each stage were selected to detect viral and bacterial pathogens. The results according to the six stages were 100 (8.3%), 259 (21.6%), 326 (27.2%), 213 (17.8%), 144 (12.0%) and 158 (13.2%) cases, respectively. Prevalence of pneumonia according to season was 87.0~96.7% and the highest prevalence was in spring. In detection of pathogens by PCR, 53 samples were not detected any causative pathogens of PRDC. PCV2, PRRSV, SIV, MH, PM, APP serotype 2, APP serotype 5 and HP were positive in 45.5%, 12.5%, 10.4%, 60.1%, 1.7%, 13.9%, 12.2% and 15.6%, respectively. In co-infection, PCV2-MH was the most detected causative pathogens of PRDC. The detection rate of PCV2 and PRRSV was the highest in spring, of SIV, MH and HP was in winter. The detection rate of APP-2 and APP-5 had no seasonal prevalence. The more severe gross lesions increased, the higher the detection rate showed.

• Tuberculosis and Respiratory Diseases
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• v.47 no.3
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• pp.321-330
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• 1999

Background : Early diagnosis and proper antibiotic treatment are very important in the management of ventilator-associated pneumonia (VAP) because of its high mortality. Bronchoscopy with a protected specimen brush (PSB) has been considered the standard method to isolate the causative organisms of VAP. However, this method burdens consumer economically to purchase a PSB. Another useful method for the diagnosis of VAP is quantitative cultures of aspirated specimens through bronchoscopic bronchoalveolar lavage (BAL), for which the infusion of more than 120 m1 of saline has been recommended for adequate sampling of a pulmonary segment. However, occasionally it leads to deterioration of the patient's condition. We studied the diagnostic efficacy of minibronchoalveolar lavage (miniBAL), which retrieves only 25 ml of BAL fluid, in the isolation of causative organisms of VAP. Methods: We included 38 consecutive patients (41 cases) suspected of having VAP on the basis of clinical evidence, who had received antibiotics before the bronchoscopy. The two diagnostic techniques of PSB and miniBAL, which were performed one after another at the same pulmonary segment, 'were compared prospectively. The cut-off values for quantitative cultures to define causative bacteria of VAP were more than $10^3$ colony-forming units (cfu)/ml for PSB and more than $10^4$ cfu/ml for BAL. Results: The amount of instilled normal saline required to retrieve 25 ml of BAL fluid was $93{\pm}32 ml$ (mean${\pm}$SD). The detection rate of causative agents was 46.3% (19/41) with PSB and 43.9% (18/41) with miniBAL. The concordance rate of PSB and miniBAL in the bacterial culture was 85.4% (35/41). Although arterial blood oxygen saturation dropped significantly (p<0.05) during ($92{\pm}10%$) and 10 min after ($95{\pm}3%$) miniBAL compared with the baseline ($97{\pm}3%$), all except 3 cases were within normal ranges. The significantly elevated heart rate during ($l25{\pm}24$/min, p<0.05) miniBAL compared with the baseline ($1l1{\pm}22$/min) recovered again in 10 min after ($111{\pm}26$/min) miniBAL. Transient hypotension was developed during the procedure in two cases. The procedure was stopped in one case due to atrial flutter. Conclusion: MiniBAL is a safe and effective technique to detect the causative organisms of VAP.

• Journal of the Korea Convergence Society
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• v.8 no.1
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• pp.51-59
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• 2017

It is to establish preliminary data about healthcare convergencr of infection control by performing a bacterial contamination test for CT scanner as well as general radiographic systems in the emergency rooms of general hospitals. The period was December 1 ~ December 31, 2015. It is detect in the emergency rooms of 7 medical facilities including 2 in Seoul, and 1 in Gyeonggi-do Province, and 2 in Jeonla-do Province, and 2 in Chungcheong-do Province. The surface contamination strains detected from CT scanner in the radiology department emergency rooms were Micrococcus species(4,5%), Stenotrophomonas maltophilia(9%), Enterococcus faecium(4.5%), Providencia stuartii(4.5), and Gram negative bacilli(4.5%). Also, the surface contamination strains detected from general radiographic system in the radiology department emergency rooms were Providencia stuartii(11%), Klebsiella pneumonia(3.5%), Stenotrophomonas maltophilia(11%), Pantoea species(11%), Acinetobacter baumannii(3.5%), Micrococcus species(3.5%), Escherichia coli(3.5%), Enterobacter species(3.5%), and Gram negative bacilli(11%). Considering that the regions of most detection were all the places closely related to patients, radiologists would have to thoroughly clean with alcohol before and after a test.

• Tuberculosis and Respiratory Diseases
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• v.59 no.1
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• pp.109-113
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• 2005

Miliary tuberculosis is the most serious form of tuberculous disease, but is rarely complicated with acute respiratory distress syndrome (ARDS). When a patient with miliary tuberculosis initially presents with ARDS, the mortality is much higher. Therefore, the early detection of miliary tuberculosis as the underlying cause of ARDS is very important for the prognosis and survival of the patient. The diagnosis of miliary tuberculosis may be easy if the patient presents typical clinical manifestations associated with the characteristic pattern of miliary nodules on chest radiology. However, the diagnosis of miliary tuberculosis when complicated with ARDS can be difficult due to the nonspecific radiologic patterns, such as diffuse bilateral consolidation and ground glass opacity, without miliary nodular infiltration. However, these nonspecific patterns are known as less likely findings of miliary tuberculosis. We experienced a pregnant woman with miliary tuberculosis, mimicking ARDS due to bilateral severe pneumonia. She was admitted, via the emergency room, with sudden onset of fever, chill, cough and dyspnea. The initial chest PA and HRCT showed diffuse bilateral consolidation and ground glass opacity, without miliary nodular infiltration. All bacteriological studies, including blood and sputum cultures, tuberculosis-PCR and serologic study for infectious disease were negative. However, the definite diagnosis of unusual miliary tuberculosis as the underlying cause of ARDS was confirmed from the radiological finding and transbronchial fiberoptic lung biopsy. We report this case, with a review of the literature.

• Journal of Environmental Health Sciences
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• v.48 no.1
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• pp.1-8
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• 2022

Objectives: The purpose of this study is to reveal the circumstances under which the cases of harm to health caused by humidifier disinfectant were neglected and show the points where the number of victims and the degree of damage could have been reduced. In addition, it attempts to describe how damage management proceeded immediately after the incident and actually exacerbated the damage. Finally, it explores the unfortunate aspects of the recent trial. By doing so, it attempts to take this as an opportunity to consider whether a tragic event such as the humidifier disinfectant incident could occur in the future. Methods: This study collected and analyzed data on chemical material characteristics related to humidifier disinfectants, data on health effect characteristics, data on related laws and regulations from the Ministry of Environment, data related to the damage investigation by the Korea Environmental Industry and Technology Institute, and current contents. Results: The lack of related systems and laws is the area where the greatest responsibility for the cause of the humidifier disinfectant disaster falls, so it is difficult for the government to escape this responsibility. Establishing a dedicated department to identify the prevalence of certain diseases within the functions of the Health Insurance Review and Assessment Service to monitor health can greatly contribute to the prevention and management of diseases through early detection and management of group outbreaks caused by harmful factors. Humidifier disinfectant damage relief should have been expanded earlier beyond HDLI (humidifier disinfectant lung injury) to include non-specific diseases such as asthma, pneumonia, and interstitial pneumonia. The scope of relief benefits should have also been expanded earlier to include the payment of disability benefits. Fortunately, with the 2020 revision of the Special Act, the conditions for estimating causal relations were eased and individual screening systems such as health impact assessment were reorganized along with the introduction of a rapid screening system. Conclusions: The management system for chemical substances in a country is clearly of paramount importance, and the ministry in charge must have a response system in case of damage to health effects. Administration that looks at the victims' situation from their point of view is needed, and technical countermeasures are required to quickly recognize the prevalence of certain diseases.

• Tuberculosis and Respiratory Diseases
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• v.64 no.3
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• pp.194-199
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• 2008

Background: Early identification of pathogens can improve the prognosis of patients with ventilator associated pneumonia (VAP). In the present study, we evaluated the feasibility of performing multiplex PCR for endotracheal aspirates to detect three important pathogens (P. aeruginosa, K. pneumoniae and MRSA) in patients with VAP. Methods: The endotracheal aspirates of 24 patients were collected within 24 hours of the diagnosis of VAP for performing multiplex PCR. Forward and reverse primers were designed to target the specific site of each pathogen (the oprL gene for P. aeruginosa, 16S rRNA for K. pneumoniae and the mec gene for MRSA). We analyzed the clinical data of the VAP patients, including the culture reports for the endotracheal aspirates. Results: Twenty-four patients (M:F=18:6, mean age=$70{\pm}11$) with VAP were enrolled. Pathogens were isolated from 11 patients (P. aeruginosa in 2, K. pneumoniae in 1, MRSA in 2, other enteric Gram negative bacilli in 3, S. pneumoniae in 2 and mixed infection in 1). Multiplex PCR detected three cases of P.aeruginosa (2 cases coincided with the culture reports) and four cases of K. pneumoniae (1 matched with the culture report). PCR detected two MRSA cases, which did not coincide with the culture reports. Conclusion: Multiplex PCR of the endotracheal aspirate showed some ability to detect Gram negative bacilli, although caution is required when interpreting the results.

• Pediatric Infection and Vaccine
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• v.25 no.3
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• pp.156-164
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• 2018

Purpose: We aimed to identify the epidemiology and the clinical characteristics of human parainfluenza virus type 4 (HPIV-4) infection compared to HPIVs 1-3 infections in Korean children. Methods: We reviewed medical records of children with HPIV infection who visited Seoul National University Children's Hospital from 2015 to 2017. Detection of respiratory viruses was performed using real time-polymerase chain reaction (rt-PCR), which could differentiate HPIVs 1-4. Diagnosis was classified as a febrile illness, upper respiratory tract infection (URI), croup, bronchiolitis, or pneumonia. The epidemiology, demographic features, and clinical characteristics among HPIV types were compared. The clinical data were analyzed only for the previously healthy children. Results: Of the 472 children diagnosed with HPIV infection, 108 (22.9%) were previously healthy: 24 (22.2%), 19 (17.6%), 39 (36.1%), and 26 (24.1%) in HPIV types 1, 2, 3, and 4, respectively. The median age of children with HPIV-4 infection was 11 (0-195) months: the proportion of children aged < 2 years and 2 to < 5 years were 65.4% and 19.2%, respectively. Clinical diagnoses of HPIV-4 infection were bronchiolitis (38.5%), pneumonia (30.8%), and URI (30.8%). Croup was the most prevalent in HPIV-2 (21.1%) and none in HPIV-4 infection (P=0.026). Hospital admission rates among HPIV types were not significantly different (P>0.05). Conclusions: We observed seasonal peak of HPIV-4 infection in 2015 and 2017. HPIV-4 was a common respiratory pathogen causing lower respiratory tract infection in hospitalized children.

• Korean Journal of Veterinary Service
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• v.38 no.2
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• pp.89-94
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• 2015

Respiratory disease in pigs is common in modern pork production worldwide and is often referred to as porcine respiratory disease complex (PRDC). PRDC is polymicrobial in nature, and results from infection with various combinations of primary and secondary respiratory pathogens. The control of swine respiratory disease requires an understanding of the interactions between the organisms that can cause this illness, the pig and management of the environment. This study was carried out to investigate the lesion of red internal organs in slaughtered pigs and provided assistant data for pig farms. A total of 900 lung samples, 45 farms were collected randomly from slaughtered pigs in Jeonbuk province from April to December in 2014. Gross lesions such as swine enzootic pneumonia (SEP), pleuritis, pleuropneumonia, pericarditis, liver white spots were examined for the pigs. Overall prevalence of SEP was 70.8%. According to season, the incidence occurred higher in summer than winter, fall and spring. The mean SEP score was 1.4, the highest incidence occurred in fall. The prevalence of pleuropneumonia, pleuritis, pericarditis, and milk spot was 26.1%, 71.4%, 2.8%, 21.6%, respectively. In the detection of pathogens, PRRS was not detected, PCV2 was positive in 87.6%.