• Tuberculosis and Respiratory Diseases
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• v.65 no.2
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• pp.91-98
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• 2008

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is the most common organism associated with nosocomial infections. MRSA infections are becoming increasing important because they have emerged no only as healthcare-associated (HA) infections but also as community-associated (CA) ones. This study examined the moleculo-epidemiology of MRSA, which was isolated from nasal swabs in the intensive care unit (ICU) at Konyang University Hospital. MRSA are classified into HA-MRSA and CA-MRSA. Methods: From June to September 2006, 353 patients who were admitted to the ICU in Konyang University Hospital were enrolled in this study. Single nasal swabs were obtained for culture in the ICU on the 1st day. Pulsed-field gel electrophoresis and the antimicrobial resistant patterns were analyzed between HA- and CA-MRSA. An antimicrobial sensitivity test was also performed. Results: Forty two strains of MRSA were isolated from 353 patients (11.9%). Among the 42 isolates, HA-MRSA and CA-MRSA were found in 33 (78.6%), and 9 (21.4%), respectively. Eleven different PFGE types (type A to K) were identified. Types A (n=9) and B (n=7) were the most common for HA-MRSA, and types A (n=2) and B (n=2) were identified in CA-MRSA. The proportion of types A and B in CA-MRSA (44.4%) was similar to that in HA-MRSA (48.5%). The rates of resistance rates to erythromycin and ciprofloxacin were higher in HA-MRSA than in CA-MRSA. Conclusion: The rate of isolation of MRSA in an ICU setting was 11.9%. HA-MRSA was isolated more frequently than CA-MRSA. The rate of resistance of HA-MRSA to erythromycin and ciprofloxacin was higher than that of CA-MRSA. Despite the small number of subjects, the main isolates (type A and B) of CA-MRSA were similar to those of HA-MRSA.

• Tuberculosis and Respiratory Diseases
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• v.60 no.3
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• pp.290-296
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• 2006

Background : IS6110 DNA fingerprint is a very useful tool for investigating the transmission of tuberculosis. The aim of this study was to identify the epidemiological situations within a given area (one province). Methods : The 681 Mycbobacterium tuberculosis isolates from patients, who were registered at health centers in Gyeonggi Province from May to December in 2004, were subjected to IS6110 DNA fingerprinting. Patients belonging to clusters were interviewed by health-workers to determine their previous contacts or household TB history. Results : The number of IS6110 copies of the 681 isolates showed diverse fingerprint patterns from 0 to 21 of which the most prevalent copy number was 10 from 120 isolates (17.6%). Thirty-three isolates (4.8%) belonged to the K strain, and 128 isolates (18.8%) belonged to the K family. There were 180 (26.4%) isolates belonged belonging to fifty clusters, of which two clusters were within household transmission. Forty-three (23.9%) out of 180 patients resided in an area under the same health center control. The rate of clusters in those aged 60-70 was higher than in any other age group ( 95% CI of RR : 1.072 ~ 1.988). Conclusion : This is the first report of an epidemiological survey based on a whole province using a DNA fingerprinting technique for M. tuberculosis. These results will be helpful in developing a program or policies to prevent the transmission of TB.

• Tuberculosis and Respiratory Diseases
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• v.60 no.3
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• pp.277-284
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• 2006

Background : Delayed treatment of pulmonary tuberculosis is an important problem because it results in greater mortality and the nosocomial transmission of tuberculosis. This study was conducted to analyze the factors that contribute to the delayed treatment of pulmonary tuberculosis in a university hospital and we wanted to provide basic data for instituting an effective management program for tuberculosis. Methods : we retrospectively reviewed the medical records of 155 patients with smear-positive or culture-positive pulmonary tuberculosis and who were treated between May 1999 and October 1999. A case-control study was performed to analyze the factors. We then tried to follow up the patients in delayed treatment group via telephone for the purpose of assessing the therapeutic interventions. Results : Among 150 patients, 55 (37%) were included in the delayed treatment group. The factors associated with delayed treatment on the univariate analysis included age (61 vs 40 years old; p <0.001), a smear-negative sputum test for acid-fast bacilli (AFB) (85% vs 55%; p <0.001) and no visits to a private clinic before the patient presented to the university hospital (56% vs 36%; p = 0.014). Multivariate analysis revealed that old age (p = 0.001), a smear-negative sputum for AFB (p = 0.001), and lower lobe infiltrate on chest X-ray (p = 0.041) were the independent predictors of delayed treatment. Of the 22 patients who did not receive any treatment, 20 of them 91%) consented to our suggestion of revisiting the hospital. Conclusion : Delayed treatment of patients with pulmonary tuberculosis is not uncommon in a university hospital. Old age, smear-negative for AFB, and lower lobe infiltrate on chest X-ray are the risk factors for delayed treatment. A more systematic management system is required for achieving better control of tuberculosis.

• Pediatric Infection and Vaccine
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• v.15 no.2
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• pp.174-179
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• 2008

Purpose : The purpose of this study was to investigate the clinical features of adolescent TB. Methods : We retrospectively reviewed the medical records of the adolescents aged 12 to 18 years and who are hospitalized with the diagnosis of TB at Dong Kang General Hospital between January 2003 and December 2007. Results : Of the 29 patients who were identified, 65.5% were male. The median age at diagnosis was 16.9 years (range: 12.1-18.9 years). A tuberculin skin test (TST) was performed for 6 patients (20.7%). Among them, 5 (5 of 8[62.5%]) in the 12-15 years age group (Group A) and 1 (1 of 21[4.8%]) in the 16-18 years of age group (Group B) were TST positive, which showed that the TST performing rate decreased with age (P<0.01). Twenty-five patients (86.2%) were detected by evaluating the clinical symptoms that suggested TB and 4 patients (13.8%) were detected by screening, but no cases were detected by contact tracing. Twenty patients (69.0%) had isolated pulmonary disease. Seven patients (24.1%) had pulmonary and extrapulmonary disease and 2 patients (6.9%) had exclusively extrapulmonary disease. Most patients presented with multiple symptoms, and the most common were cough (79.3%), fever (75.9%), sputum (65.8%) and chest pain (34.5%). M. tuberculosis was isolated from the sputum of 20 patients (69.0%). The culture-positive rate increased with age (range: 62.5% in Group A to 71.4% in Group B), but the difference between the groups was not significant. Cavitary lesions were found 13 patients (44.8%). The cavitary lesion rate increased with age (range: 25.0% in Group A to 52.4% in Group B), but the difference between the groups was not significant. Four patients (13.8%) were lost during follow-up. One patient (6.9%) relapsed. Conclusion : Clinicians need to be aware of the unique features of adolescent TB, and they also need awareness of the importance of TST and contact investigation for an adult suspected of having TB for making the diagnosis of TB.

• The Korean Journal of Nuclear Medicine
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• v.34 no.3
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• pp.169-182
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• 2000

Purpose: To investigate the various ictal perfusion patterns and find the relationships between clinical factors and different perfusion patterns. Materials and Methods: Interictal and ictal SPECT and SPECT subtraction were performed in 61 patients with partial epilepsy. Both positive images showing ictal hyperperfusion and negative images revealing ictal hypoperfusion were obtained by SPECT subtraction The ictal perfusion patterns of subtracted SPECT were classified into focal hyperperfusion, hyperperfusion-plus, combined hyperperfusion-hypoperfusion, and focal hypoperfusion only. Results: The concordance rates with epileptic focus were 91.8% in combined analysis of ictal hyperperfusion and hypoperfusion images of subtracted SPECT, 85.2% in hyperperfusion images only of subtracted SPECT, and 68.9% in conventional ictal SPECT analysis. Ictal hypoperfusion occurred less frequently in temporal lobe epilepsy (TLE) than extratemporal lobe epilepsy. Mesial temporal hyperperfusion alone was seen only in mesial TLE while lateral temporal hyperperfusion alone was observed only in neocortical TLE. Hippocampal sclerosis had much lower incidence of ictal hypoperfusion than any other pathology. Some patients showed ictal hypoperfusion at epileptic focus with ictal hyperperfusion in the neighboring brain regions where ictal discharges propagated. Conclusion: Hypoperfusion as well as hyperperfusion in ictal SPECT should be considered for localizing epileptic focus. Although the mechanism of ictal hypoperfusion could be an intra-ictal early exhaustion of seizure focus or a steal phenomenon by the propagation of ictal discharges to adjacent brain areas, further study is needed to elucidate it.

• Korean Journal of Ecology and Environment
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• v.47 no.4
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• pp.350-357
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• 2014

Harmful Algal Bloom Alert System (HABAS) for drinking water supply is require to fast and accurate count as system monitoring of cyanobacterium occurrence and inducing a response action. We measured correlation between colony size and cell number including genus Anabaena, Aphanizomenon, Microcystis, Oscillatoria which are targeted at HABAS, deducted from standard formula, and suggested calculation method from colony size to the number of cell. We collected cyanobacteria samples at Han River (Paldang reservoir), Nakdong River (Dalseong weir, Changnyeonghaman weir) and Geum River (Gobok reservoir) from August to October, 2013. Also, we studied correlation between colony size and cell number, and calculated regression equation. As a result of correlation of harmful cyanobacteria by genus, Anabaena spp. and Aphanizomenon spp. having trichome showed high correlation coefficients more than 0.93 and Microcystis spp. having colony showed correlation coefficient of 0.76. As a result of correlation of harmful cyanobacteria by species, Anabaena crassa, Aphanizomenon flos-aquae, A. issatschenkoi, Oscillatoria curviceps, O. mougeotii having trichome showed high correlation coefficients from 0.89 to 0.96, and Microcystis aeruginosa, M. wessenbergii, M. viridis having colony showed correlation coefficients from 0.76 to 0.88. Compared with other genus Microcystis relatively showed low correlation because even species and colony size are the same, cell density and cell size are different from Microcystis strains. In this study, using calculated regression might be fast and simple method of cell counting. From now on, we need to secure additional samples, and make a decision to study about other species.

• Journal of fish pathology
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• v.30 no.2
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• pp.89-96
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• 2017

The majority of freshwater ornamental fish are imported and distributed domestically, causing high risk of exposure to exotic pathogens and drug resistant bacteria in Korea. Aeromonas hydrophila is known as a common species of fresh water bacteria and opportunistic fish pathogen, as well as a species causing zoonotic infection. In this study, we isolated motile aeromonads from various imported freshwater ornamental fish and studied the characters of the isolates. Imported freshwater ornamental fish were purchased on day 1 after the fish were deposited in the aquarium. Bacteria were isolated from the liver, kidney and spleen of fish using 0.5% NaCl containing tryptic soy agar medium. Bacteria were grouped on the basis of their morphological characteristics. The colonies with clear zone on starch-ampicillin agar (SA agar) were tentatively identified as Aeromonas spp. Two hundred and twenty-six strains, about 70% of total isolates were assumed to be Aeromonas spp. Nine isolates were further identified based on the result of the API 20E test and PCR using primers specific for A. hydrophila 16S rRNA gene. The isolates were identified as A. hydrophila and the API 20E test showed differences in trisodium citrate, D-sucrose, D-melibiose, amygdalin and L-arabinose availability between the nine isolates and standard A. hydrophila. The susceptibilities of the isolated bacteria to 10 antibacterial agents were confirmed by the disk diffusion method. Isolated strains were found to be resistant to amoxicillin and ampicillin and sensitive to florfenicol. However, 7 isolates showed multiple drug resistances to erythromycin, oxytetracycline, nalidixic acid etc. Pathogenicity of the isolates was determined by the artificial challenge test on goldfish (Carassius auratus). Three isolates caused 60 ~ 80% mortality in goldfish within 5 days after the initiation of challenge. These results indicate that multiple drug resistant, highly pathogenic and exotic A. hydrophila can spread to domestic aquarium and the preventive treatment of fish before sale is necessary.

• Journal of dental hygiene science
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• v.17 no.4
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• pp.341-351
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• 2017

This study aimed to investigate the medically inclined college students' knowledge, attitude, and compliance on the preventive behaviors of the Middle East respiratory syndrome (MERS). A cross-sectional study was conducted on 251 medically inclined college students in Jeonju Kijeon College from June 8 to 13, 2015, using a scale on the knowledge and attitude toward MERS and a structured questionnaire. The t-test, analysis of variance, and Pearson correlation coefficient were used to analyze the data. The participants consisted of 46.6% college students majoring in dental hygiene, 30.7% in clinical pathology, and 22.7% in emergency rescue, and 69.7% of them had been educated on MERS prevention. This study revealed that students who received MERS prevention training (t=3.457, p=0.001) and female students (t=-2.945, p=0.005) had more knowledge on MERS, while students from the dental hygiene department (F=8.048, p<0.001) and those in their third year (F=3.978, p=0.020) showed a more positive attitude toward MERS. Regarding the correlation between knowledge, attitude, fear of infection and compliance on the preventive behaviors, students were more knowledgeable (r=0.133, p=0.036), presented a more positive attitude (r=0.158, p=0.012) and had more fear of infection (r=0.312, p<0.001), were more likely to comply with the preventive measures. For an effective prevention of MERS, a newly found infectious disease, we suggest that medically inclined college students must improve their knowledge of and have a positive attitude toward MERS infection management at a medical institution in compliance with the MERS infection preventive behaviors. Furthermore, this study shows that an infection management education program should be developed, so that which students could learn about the causes, dissemination routes, and preventive methods of infectious diseases, including the newly discovered ones, prior to their clinical training at a medical institution.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.14 no.1
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• pp.67-73
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• 2011

Purpose: Recently, the incidence of acute hepatitis A has increased nationwide and is related to a low rate of IgG anti-HAV production. To establish effective measures for preventing hepatitis A virus infection, an epidemiologic study on the seroprevalence of anti-HAV is needed. Thus, we investigated the seroprevalence of IgG anti-HAV in children living in Gwangju and Jeonnam. Methods: IgG anti-HAV levels were measured in a total of 1,435 patients who visited Chosun University Hospital between January 2009 and December 2009. Results: The overall seropositve rate was 40.8% (586/1,435). The seropositive rates were 41% among children under the age of 1 year, 49.9% for children 1~5 years old, 51.1% among individuals 5~10 years old, 12.9% for individuals 10~15 years old, and 8.2% for subjects over 15 years old. There was no significant difference between genders in any group. The seropositive rates in Gwangju and Jeonnam were 57.3% and 32.9% for children under the age of 1 year, 52.5% and 44.3% for children 1~5 years old, 60.2% and 33.9% among children 5~10 years old, 14.1% and 9.7% for children 10~15 years old, and 10.8% and 4.2% for individuals over 15 years old. Conclusion: The results demonstrated the low rates of IgG anti-HAV, particularly among subjects over 10 years old, which suggests the possibility of increasing clinical HAV infection rates among adults in the near future. We should actively prevent the spread of hepatitis A virus. Vaccination is the most effective means of preventing hepatitis A virus transmission among persons at risk for infection. Hepatitis A vaccination is recommended for children who have low IgG anti-HAV seropositive rates.

• Pediatric Infection and Vaccine
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• v.6 no.1
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• pp.107-115
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• 1999

Purpose : Enterobiasis is probably one of the most common parasitic infection world-wide. Human is the only known host of Enterobius vermicularis. Children are more commonly infected with Enterobius vermicularis than adults and infections are commonly recurred. In Korea, there is a high prevalence. So, we performed this study to evaluate the present status of Enterobius vermicularis infection among children in the Masan, Changwon areas and to determine the efficacy of flubendazole against this parasitic nematode. Methods : From November to December, 1997, urban and rural elementary school children and urban preschool children were examined for the presence of Enterobius vermicularis egg. All the children were examined once by an adhesive cellotape anal swab technique in the early morning at home by their parents guided by specific instructions for the technique. Results : 1) A total of 644 adhesive cellotape anal swab specimens was collected from 205 urban elementary school children, 290 rural elementary school children and 145 urban preschool children. Among them, 114(17.7%) were positive for Enterobius vermicularis eggs. There was no significant differences in the rate with regard to sex. 2) In the preschool children, the egg detection rate was 42(29.0%) out of 145 children. This rate was significantly higher compared with 72(14.4%) of 499 school children. 3) The egg detection rates in the rural and urban school children were 15.2, 13.7% respectively. There was no significant difference in both groups. In the 3rd grade and below in elementary school children, there was a higher rate compared with above 4th grade group. 4) In day care center where egg detection rate was high as 41%, the children were given two doses of 100mg flubendazole every 3 weeks, including staffs and family members. After treatment, egg detection rate fatted as 6%. Conclusion : Our data demonstrated that there was high prevalence of Enterobius vermicularis infection. In the light of these results, it is necessary to examine and treat children as soon as possible.