• Journal of Yeungnam Medical Science
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• v.40 no.3
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• pp.283-288
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• 2023

Severe chronic neutropenia is classified as severe congenital, cyclic, autoimmune, or idiopathic. However, there is a lot of uncertainty regarding the diagnosis of severe congenital neutropenia (SCN) and chronic idiopathic neutropenia, and this uncertainty affects further evaluations and treatments. A 20-year-old man presented with fever and knee abrasions after a bicycle accident. On admission, his initial absolute neutrophil count (ANC) was 30/µL. He had no medical history of persistent severe neutropenia with periodic oscillation of ANC. Although his fever resolved after appropriate antibiotic therapy, ANC remained at 80/µL. Bone marrow (BM) aspiration and biopsy were performed, and a BM smear showed myeloid maturation arrest. Moreover, genetic mutation test results showed a heterozygous missense variant in exon 4 of the neutrophil elastase ELANE: c597+1G>C (pV190-F199del). The patient was diagnosed with SCN. After discharge, we routinely checked his ANC level and monitored any signs of infection with minimum use of granulocyte colony-stimulating factor (G-CSF), considering its potential risk of leukemic transformation. Considering that SCN can be fatal, timely diagnosis and appropriate management with G-CSF are essential. We report the case of a patient with SCN caused by ELANE mutation who had atypical clinical manifestations. For a more accurate diagnosis and treatment of severe chronic neutropenia, further studies are needed to elucidate the various clinical features of ELANE.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.2
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• pp.68-74
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• 2023

Objectives: Drug holidays are suggested to reduce the formation of osteonecrosis in patients under intravenous (IV) bisphosphonates (BPs) therapy. The objectives of this study are to evaluate the incidence of medication-related osteonecrosis of the jaw (MRONJ) following tooth extraction in cancer patients using IV BP, and to assess the effect of drug holiday on the development of MRONJ. Patients and Methods: A manuel search of the patient folders of Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hacettepe University was undertaken to identify cancer patients who used IV BPs and had at least one tooth extraction between 2012 and 2022. Patents' age, sex, systemic condition, the type of BP used, duration of BP used, number of tooth extraction, duration of drug holiday, localization of tooth extraction and incidence of MRONJ were recorded. Results: One hundred nine teeth were removed from 57 jaws in 51 patients. All tooth extractions were performed under perioperative antibiotic prophylaxis and with primary wound closure. The incidence of MRONJ was 5.3%. Stage 1 MRONJ developed in 3 patients (only one had a drug holiday). The median duration of drug holiday was 2 months. No significant difference between the patients with and without a drug holiday and MRONJ development was found (P=0.315). The mean age of patients developed MRONJ was 40.33±8.08 years. A statistically significant difference was found between age and MRONJ development (P=0.002). Conclusion: The effect of a short-term drug holiday on the development of MRONJ may be limited because BPs remain in bone tissue for a long time. Drug holidays should be applied with the approval of an oncologist with other preventive measurements.

• The Journal of Internal Korean Medicine
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• v.44 no.3
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• pp.455-465
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• 2023

Inflammatory bowel disease (IBD) is defined as a chronic inflammatory-mediated disease that causes ulceration and inflammation in the gastrointestinal tract. Among most patients, the course of chronic inflammation repeatedly shows intermittent exacerbations and alternating remissions. However, despite the various therapeutic options to relieve symptoms, such as corticosteroids, TNF-α inhibitors, and antibiotic drugs, there is no known cure for IBD. Nonetheless, previous research has revealed that the autonomic nervous system is involved in the pathophysiology of IBD. In this study, we reviewed clinical trials confirming the therapeutic effect of vagus nerve stimulation (VNS) on IBD in vivo. We searched in vivo and human studies on Pubmed using keywords combined with "vagus nerve stimulation", "VNS", and "inflammatory bowel disease". All studies included in this review reported that direct VNS is effective in relieving symptoms of IBD and has no severe adverse effects. The most frequently stimulated site was the unilateral cervical vagus nerve area, and parameters for stimulation were set as 5-20 Hz. Based on the results, we aim to summarize the evidence for the efficacy of VNS on IBD and suggest the possibility of auricular electroacupuncture treatment as a therapeutic option for IBD.

• Journal of the Korean Society of Radiology
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• v.81 no.3
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• pp.733-738
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• 2020

Aortic aneurysms infected by Klebsiella pneumoniae are rarely seen. We describe a 50-year-old man with infected aortic aneurysm that was successfully treated with endovascular aneurysm repair (EVAR). Diagnosis was confirmed using blood culture and computed tomography (CT). Intravenous antibiotics were immediately administered, with improvements in clinical findings and negative blood cultures before the procedure. Twenty-four months after the procedure, the patient was stable and serial CT revealed regression of the infected aortic aneurysm. Therefore, after controlling bacteremia and fever with targeted antibiotic therapy, EVAR can be considered as an alternative for patients who have serious comorbidities and are ineligible for conventional surgery.

• Pediatric Infection and Vaccine
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• v.30 no.3
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• pp.165-172
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• 2023

Pyogenic liver abscess is a rare condition in healthy children in developed countries, but it can have severe consequences if diagnosis and treatment are delayed. Staphylococcus aureus is the most commonly identified cause of pyogenic liver abscess worldwide, while Klebsiella pneumoniae is the predominant causative agent in Korea. However, cases of pyogenic liver abscess caused by anaerobic bacteria have also been rarely reported. A 14-year-old boy presented to the emergency room with fever and pain in the upper right abdomen. He exhibited tenderness in the right upper quadrant, elevated white blood cell count, anemia, and elevated liver enzyme levels. Abdominal computed tomography with contrast revealed pyogenic liver abscess. The patient underwent percutaneous catheter drainage for two weeks and received a 4-week course of antibiotic therapy. Prevotella intermedia, an anaerobic bacterium commonly found in the oral flora, was isolated from the drained pus. However, no evidence was found suggesting that the infection originated from a dental source. This case highlights the importance of considering the possibility of pyogenic liver abscess even in otherwise healthy children.

• The Korean Journal of Physiology and Pharmacology
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• v.28 no.1
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• pp.21-30
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• 2024

The challenging clinical outcomes associated with advanced cervical cancer underscore the need for a novel therapeutic approach. Monensin, a polyether antibiotic, has recently emerged as a promising candidate with anti-cancer properties. In line with these ongoing efforts, our study presents compelling evidence of monensin's potent efficacy in cervical cancer. Monensin exerts a pronounced inhibitory impact on proliferation and anchorage-independent growth. Additionally, monensin significantly inhibited cervical cancer growth in vivo without causing any discernible toxicity in mice. Mechanism studies show that monensin's anti-cervical cancer activity can be attributed to its capacity to inhibit the Wnt/β-catenin pathway, rather than inducing oxidative stress. Monensin effectively reduces both the levels and activity of β-catenin, and we identify Akt, rather than CK1, as the key player involved in monensin-mediated Wnt/β-catenin inhibition. Rescue studies using Wnt activator and β-catenin-overexpressing cells confirmed that β-catenin inhibition is the mechanism of monensin's action. As expected, cervical cancer cells exhibiting heightened Wnt/β-catenin activity display increased sensitivity to monensin treatment. In conclusion, our findings provide pre-clinical evidence that supports further exploration of monensin's potential for repurposing in cervical cancer therapy, particularly for patients exhibiting aberrant Wnt/β-catenin activation.

• Tuberculosis and Respiratory Diseases
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• v.58 no.6
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• pp.576-581
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• 2005

Background : Thoracic actinomycosis is a relatively uncommon anaerobic infection caused by Actinomyces israelii. There have been only a few case reports of endobronchial actinomycosis. The aim of this study was to evaluate the clinical manifestation and treatment of endobronchial actinomycosis. Material and Methods : Seven patients with endobronchial actinomycosis, who were diagnosed in the past 10 years, were retrospectively reviewed. Results : Cough and sputum were the most common symptoms. The chest radiograph and computed tomography showed necrotic consolidation (n=3), atelectasis (n=2), mass (n=1) and an endobronchial nodule (n=1). Proximal broncholithiasis was observed in five patients. All cases were initially suspected to have either lung cancer or tuberculosis. In these patients, the median duration of intravenous antibiotics was 3 days (range 0-12 days) and the median duration of oral antibiotics was 147 days (range 20-412 days). Two patients received oral antibiotic therapy only. There was no clinical evidence of a recurrence. Conclusion : Endobronchial actinomycosis frequently manifests as a proximal obstructive calcified endobronchial nodule that is associated with distal post-obstructive pneumonia. The possibility of endobronchial actinomycosis is suggested when findings of broncholithiasis are present at chest CT. The traditional recommendation of 2-6 weeks of intravenous antibiotics and 6-12 months of oral antibiotic therapy are not necessarily essential in all cases of endobronchial actinomycosis.

• Journal of Animal Science and Technology
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• v.51 no.1
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• pp.25-32
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• 2009

This study was conducted to determine the effects of probiotics supplementation on growth performance, nutrient digestibility, occurrence of diarrhea and immune response in weaning pigs. Treatments were 1) NC (basal diet), 2) PC (basal diet + 0.12% avilamycin) and 3) A (basal diet + 0.2% Aspergillus oryzae), 4) B (basal diet + 0.2% Lactobacillus casei), 5) C (basal diet + 0.2% Bacillus subtilis), 6) D (basal diet + 0.2% Lactobacillus crispatus). A total of 120 pigs ($7.16\pm0.01$ kg average body weight, weaned at $23\pm3$days of age) were assigned to 6 treatments, 5 replicates and 4 pigs per pen in a randomized complete block (RCB) design. During the whole experimental period, body weight (P<0.01), average daily gain (ADG; P<0.01), and average daily feed intake (ADFI; P<0.05) of treatment PC were higher than other treatments. However, the probiotics treatments tended to increase ADG and G:F ratio compared to treatment NC. The G:F ratio in treatment A (Aspergillus oryzae) was similar to treatment PC during the whole experimental period (P<0.05). The supplementation of probiotics in the diet of weaning pig did not change nutrient digestibility (dry matter, crude protein, crude fat and ash) and nitrogen retention of weaning pigs. In blood urea nitrogen (BUN) concentration, treatment B had lower value than other treatments at 2 and 4 weeks (P<0.05). Treatments PC and C tended to decrease diarrhea score than other treatments (P=0.18). At 3h after lipopolysaccharide (LPS) injection, treatments NC and PC had higher count of $CD^{4+}$ T-cells than probiotics treatments, and treatment C showed the lowest value (P<0.01). There were no differences on count of $CD^{8+}$ T-cells and $CD^{4+}:CD^{8+}$ ratio among all treatments (P>0.10). These results suggest that the dietary probiotics are likely able to improve the growth performance, occurrence of diarrhea and immune response although they do not have similar effects like antibiotics in weaning pigs.

• Korean Journal of Environmental Agriculture
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• v.30 no.3
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• pp.295-303
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• 2011

BACKGROUND: Anaerobic digestion process is recently adapted technology for treatment of organic waste such as animal manure because the energy embedded in the waste can be recovered from the waste while the organic waste were digested. Ever increased demand for consumption of meat resulted in the excessive use of antimicrobials to the livestocks for more food production. Most antimicrobials administered to animals are excreted through urine and feces, which might highly affect the biological treatment processes of the animal manure. The aim of this study was to investigate the effects of antimicrobials on the efficiency of anaerobic digestion process and to clarify the interactions between antimicrobials and anaerobes. METHODS AND RESULTS: The experiment was consisted of two parts 1) batch test to investigate the effects of individual antibiotic compounds on production of methane and VFAs(volatile fatty acids), and removal efficiency of organic matter, and 2) the continuous reactor test to elucidate the effects of mixed antimicrobials on the whole anaerobic digestion process. The batch test showed no inhibitions in the rate of methane and VFAs production, and the rate of organic removal were observed with treatment at 1~10 mg/L of antimicrobials while temporary inhibition was observed at 50 mg/L treatment. In contrast, treatment of 100 mg/L antimicrobials resulted in continuous decreased in the rate of methane production and organic removal efficiency. The continuous reactor test conduced to see the influence of the mixed antimicrobials showed only small declines in the methane production and organic matter removal when 1~10 mg/L of combined antimicrobials were applied but this was not significant. In contrast, with the treatment of 50 mg/L of combined antimicrobials, the rate of organic removal efficiency in effluent decreased by 2~15% and the rate of biogas production decreased by 30%. CONCLUSION(s): The antimicrobials remained in the animal manure might not be removed during the anaerobic digestion process and hence, is likely to be released to the natural ecosystem. Therefore, the efforts to decline the usage of antimicrobials for animal farming would be highly recommended.

• Asian-Australasian Journal of Animal Sciences
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• v.24 no.5
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• pp.655-661
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• 2011

Two experiments were conducted to investigate the effect of dietary supplementation of Bacillus, Saccharomyces and lactic acid bacteria (LAB) on performance and nutrient digestibility in grower and finisher pigs. In Exp. 1, 80 pigs (32 females and 48 males), $28.7{\pm}0.9\;kg$ body weight (BW), were randomly divided into 4 treatment groups balanced for sex and weight (5 pigs per pen, 4 pens per treatment). They were fed one of four diets: a basal grower (20-50 kg BW) and finisher (>50 kg BW) diet without any addition of probiotic or antibiotic (diet C), the basal diet supplemented with Bacillus subtilis H4 (diet B), diet B supplemented with Saccharomyces boulardi Sb (diet BS) and diet BS supplemented with a LAB complex (diet BSL). The LAB complex consisted of Enterococcus faecium 6H2, Lactobacillus acidophilus C3, Pediococcus pentosaceus D7, and Lactobacillus fermentum NC1. In Exp. 2, 16 male pigs, $29.2{\pm}0.8\;kg$ BW, were kept in individual pens and divided into 4 groups (4 pigs in each group). All 4 groups were given exactly the same growing-period diets (diet C, B, BS and BSL) as in Exp 1. The total faeces and urine were collected during 5 days (day 20-24) to determine nitrogen retention and total tract digestibility. In the growing period, average daily feed intake (ADFI), average daily gain (ADG) and feed conversion ratio (FCR) were not affected by diet B and BS (p>0.05), but ADG increased (+5.9%) (p<0.05) and FCR improved (+5.9%) (p<0.05) on diet BSL compared with the control, although ADFI was not different (p>0.05). Digestibility of crude protein and organic matter was higher (p<0.05) in diet BSL and digestibility of crude fibre was higher (p<0.05) in diet BS and BSL than in diet C. Nitrogen retention was not affected by diet (p>0.05). The faecal LAB counts were increased in grower pigs fed diet BSL (p<0.05) and faecal E. coli counts were decreased in pigs fed diets BS and BSL (p<0.05). In the finishing period, no effects of diet were found in ADFI, ADG, FCR, nutrient digestibility, and nitrogen retention (p>0.05). Faecal LAB and E. coli counts in the finisher pigs were not affected by diet (p>0.05). In conclusion, the current study demonstrates that a mixture of bacteria and yeast has the potential to be used as a probiotic dietary supplement in grower pigs.