• Proceedings of the Korean Environmental Health Society Conference
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• 2005.06a
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• pp.45-72
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• 2005

C. neoformans-associated cryptococcosis is primarily a disease of immunocompromised persons, has a world-wide distribution, and is often spread by pigeons in the urban environment. In contrast, C. gattii causes infection in normal hosts, has only been described in tropical and semi-tropical areas of the world, and has a unique niche in river gum Eucalyptus trees. Cryptococcosis is acquired through inhalation of the yeast propagules from the environment. C. gattii has been identified as the cause of an emerging infectious disease centered on Vancouver Island, British Columbia, Canada. No cases of C. gattii-disease were diagnosed prior to 1999; the current incidence rate is 36 cases per million population. A search was initiated in 2001 to find the ecological niche of this basidiomycetous yeast. C. gaftii was found in the environment in treed areas of Vancouver Island. The highest percentage of colonized-tree clusters were found around central Vancouver Island, with decreasing rates of colonization to the north and south. Climate, soil and vegetation cover of this area, called the Coastal Douglas fir biogeoclimatic zone, is unique to British Columbia and Canada. The concentration of airborne C. gattii was highest in the dry summer months, and lowest during late fall, winter, and early spring, months which have heavy rainfall. The study of the emerging colonization of this organism and subsequent cases of environmentally acquired disease will be informative in planning public health management of new routes of exposure to exotic agents in areas impacted by changing climate and land use patterns. Cryptococcosis is an infection associated with an encapsulated, basidiomycetous yeast Cryptococcus neoformans. The route of entry for this organism is through the lungs, with possible systemic spread via the circulatory system to the brain and meninges. There are four cryptococcal serogroups associated with disease in humans and animals, distinguished by capsular polysaccharide antigens. Cryptococcus neoformans: variety grubii (serotype A), variety neoformans (serotype D), and variety gattii (serotypes B and C) (Franzot et at. 1999). C. neoformans variety gattii has recently been elevated to species status, C. gattii. C. neoformans val. grubii and var. neoformans have a world-wide distribution, and are particularly associated with soil and weathered bird droppings. In contrast, C. gattii (CG) is not associated with bird excrement, is primarily found in tropical and subtropical climates, and has a restricted environmental niche associated with specific tree species. (Ellis & Pfiffer 1990) Ellis and Pfeiffer theorize that, as a basidiomycete, CG requires an association with a tree in order to become pathogenic to mammals. In Australia, CG has been found to be associated with five species of Eucalypts, Eucalyptus camaldulensis, E. tereticornis, E. blakelyi, E. gomphocephala, and E. rudis. Eucalypts, although originally native to Australia, now have a world-wide distribution. CG has been found associated with imported eucalypts in India, California, Brazil, and Egypt. In addition, in Brazil and Columbia, where eucalypts have been naturalized, native trees have been shown to harbour CG (Callejas et al. 1998; Montenegro et al. 2000). In British Columbia, Canada, since the beginning of 1999, there have been 120 confirmed cases of cryptococcal mycoses associated with CG in humans, including 4 fatalities (data from British Columbia Centre for Disease Control), and over 200 cases in animal pets in BC (data from Central Laboratory for Veterinarians). What is remarkable about the BC outbreak of C. gattii-cryptococcosis is that all of the cases have been residents of, or visitors to, a narrow area along the eastern coast of Vancouver Island, BC, from the tip of the island in the south (Victoria) to Courtenay on the north-central island as illustrated in Figure 1. Of the first 38 human cases, 58% were male with a mean age of 59.7 years (range 20 - 82): 36 cases (95%) were Caucasian. Ten cases (26%) presented with meningitis, the remainder presented with respiratory symptoms. Cultures recovered from cases of cryptococcosis associated with the outbreak were typed as serogroup B, which is specific to CG (Bartlett et al. 2003). This was the first reported outbreak of CVG in Canada, or indeed, the world. Where infection with CG is endemic, for example, Australia, the incidence of cryptococcosis ranges from 1.8 - 4.7 per million between the southern and northern states (Sorrell 2001). However, the overall incidence of cryptococcosis in immunocompenent individuals has been estimated at 0.2 per million population per year (Kwon-Chung et al. 1984). The population of Vancouver Island is approximately 720,000,consequently, even if the organism were endemic, one would expect a maximum of 0.15 cases of cryptococcal disease annually.

• Tuberculosis and Respiratory Diseases
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• v.73 no.5
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• pp.273-277
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• 2012

Paraneoplastic limbic encephalitis (PLE) is a rare syndrome characterized by memory impairment, affective and behavioral disturbances and seizures. Among many different neoplasms known to cause PLE, small cell lung cancer (SCLC) is the most frequently reported. The pathogenesis is not fully understood but is believed to be autoimmune-related. We experienced a patient with typical clinical features of PLE. A 67-year-old man presented with seizure and disorientation. Brain magnetic resonance imaging demonstrated high signal intensity in the bilateral amygdala and hippocampus in flair and T2-weighted images suggestive of limbic encephalitis. Cerebrospinal fluid tapping revealed no evidence of malignant cells or infection. Positron emission tomography/computed tomography showed a lung mass with pleural effusion and a consequent biopsy confirmed the diagnosis of PLE associated with SCLC. The patient was subsequently treated with chemotherapy and neurologic symptoms gradually improved.

• Pediatric Infection and Vaccine
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• v.14 no.1
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• pp.55-61
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• 2007

Purpose : Fever, the most common presenting symptom in pediatric clinics, has been believed to be a dangerous symptom by many parents. Proper recognition about fever will relieve unnecessary anxiety of parents and help them understand the course of the disease. Our objectives of this study were to investigate current parental recognition about fever and to compare these results with those described in 1992. Methods : Between May and July 2006, we questioned caregivers who visited the pediatric outpatient clinic in St.Paul hospital. The questionnaire consisted of 19 items asking about recognition, attitude and management of fever. Results : A total of 136 caregivers were interviewed. Compared with 10 years ago, there were no significant improvements in misconception about fever. Many caregivers (61%) had wrong information about a definition and the way to measure body temperature. There were still high concerns about febrile convulsion and brain damage from fever. Caregivers started treatment at the body temperature which actually needed no therapy. Conclusion : Parents were not aware that fever is just one of physiologic responses and has benefits, which led to unnecessary anxiety and treatment. This misconception has not been changed over the years. Pediatrician should inform parents that fever itself is not harmful and only rational reason for use of antipyretics is to relieve a discomfort of a febrile child. An educational interventions offered by pediatricians will be helpful for parents to have right attitude and understandings toward fever.

• Journal of dental hygiene science
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• v.8 no.3
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• pp.183-187
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• 2008

The objective of this study was to assess the level of contamination of dental equipment surfaces by Staphylococcus aureus and to obtain basic information for the prevention against cross infection between students and outpatients. Human samples were collected by rubbing the oral cavity, anterior noses, and lip of students and outpatients with sterile cotton swabs. Environmental samples were collected from 11 sites at practical laboratory, 4 sites at seminar room, and 5 sites at sterilizing room before, during, and after clinical procedures. These samples were cultured on brain-heart infusion agar at $37^{\circ}C$ for 24 hours. Gram-stained and identified as S. aureus colonies were counted each period and these results were analyzed by t-test and ANOVA test. In human, oral cavity showed the greatest S. aureus counts and there were no statistically significant differences between students and outpatient. Practical laboratory revealed the greatest S. aureus among all environmental groups. The greatest number of S. aureus was observed during clinical procedures (P < 0.05) and light handles, chair head, and spittoon showed a high level of statistically significant differences. In conclusion, S. aureus was dispersed in human and dental clinical environment and increased their number during clinical procedures.

• Korean Journal of Ichthyology
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• v.29 no.3
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• pp.157-164
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• 2017

In 2015, a nervous necrosis virus (NNV) was isolated from sevenband grouper, Epinephelus septemfasciatus, maintained in land-based aquaculture system at below $12^{\circ}C$ in winter. Mortality was up to 30% in brood fish, over 4 kg of body weight. Moribund fish showed clinical sings typical of viral encephalopathy and retinopathy (VER), also called viral nervous necrosis (VNN), such as uncoordinated, corkscrew-like swimming behavior, belly-up at rest, darkening of body, cloudy eyeball and hyperinflation of the swim bladder. Aetiology of the disease was confirmed by gross observation of clinical signs, histopathology and molecular diagnosis. Histological studies revealed severe vacuolation and necrosis in the brain. Molecular diagnosis by revere transcription-polymerase chain reaction (RT-PCR) specific to batanodavirus yielded a positive result. The nucleotide sequences of the PCR-amplified fragment were 99.48~100% similar to barfin flounder nervous necrosis virus (BFNNV) genotype and most closely aligned with Pacific cod betanodavirus (PCNNV). This is the first report of natural batanodavirus, NNV infection in sevenband grouper reared in low water temperature during winter (below $12^{\circ}C$) in Korea.

• Journal of fish pathology
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• v.10 no.1
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• pp.21-29
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• 1997

We investigated on the prevalence and extermination of scuticociliatids parasitic on cultured japanese flounder, Paralichthys olivaceus in land-marine tank system of southern Korea from January to February in 1997. The gills and the skin showed the highest infection rate(60%), and the brain showed the lowest(22%). Also, fish secreted large quantity of mucus with a bleeding and ulcerated lesions on the infected sites. The number of the parasites in inflowing sea water, surface water and bottom water of farming tank ranged 0~1 individuals/$100m\ell$, 0~413 individuals/$100m\ell$ and $7\sim7.3{\times}10^4$ individuals/$100m\ell$, respectively. This parasite was died within 2 hours in 50~500 ppm, 48 hours of 10 ppm formalin or hydrogen peroxide, 1 hour in 50~500 ppm, 80 minutes of 10 ppm oligo chitosan and 10 minute in 100% but did not died until 48 hours in 10~70% fresh water.

• Archives of Plastic Surgery
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• v.41 no.6
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• pp.679-685
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• 2014

Background Frontal sinus fractures, particularly anterior sinus fractures, are relatively common facial fractures. Many agree on the general principles of frontal fracture management; however, the optimal methods of reduction are still controversial. In this article, we suggest a simple reduction method using a subbrow incision as a treatment for isolated anterior sinus fractures. Methods Between March 2011 and March 2014, 13 patients with isolated frontal sinus fractures were treated by open reduction and internal fixation through a subbrow incision. The subbrow incision line was designed to be precisely at the lower margin of the brow in order to obtain an inconspicuous scar. A periosteal incision was made at 3 mm above the superior orbital rim. The fracture site of the frontal bone was reduced, and bone fixation was performed using an absorbable plate and screws. Results Contour deformities were completely restored in all patients, and all patients were satisfied with the results. Scars were barely visible in the long-term follow-up. No complications related to the procedure, such as infection, uncontrolled sinus bleeding, hematoma, paresthesia, mucocele, or posterior wall and brain injury were observed. Conclusions The subbrow approach allowed for an accurate reduction and internal fixation of the fractures in the anterior table of the frontal sinus by providing a direct visualization of the fracture. Considering the surgical success of the reduction and the rigid fixation, patient satisfaction, and aesthetic problems, this transcutaneous approach through a subbrow incision is concluded to be superior to the other reduction techniques used in the case of an anterior table frontal sinus fracture.

• Parasites, Hosts and Diseases
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• v.32 no.1
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• pp.19-26
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• 1994

An in uipo culturing to examine the cyst stage of ToxopLQsma gondii (ME49 strain) was Investigated using murine peritoneal macrophages, and we also examined the effect of CAMP or DHFR Inhibitors on the growth of bradyzoltes. For experiments ICR mice were Injected 1.p. with 1,500 brain cysts. At 1, 3, 5 and 7 days, peritoneal exudates were Isolated and then adherent peritoneal macrophages were cultured for 1,3,5 and 10 days. Growth pattern of bradyzoltes was measured by (3H)-uracil uptake assay and morphological pattern of pseudocysts formed in macrophages was observed Uth Glemsa stain. Mostly bradyzoites were observed In the macrophages extracted at 3 and S days post Infection. After 3 days in vitro, a number of pseudocysts were formed in the macrophages and the size of pseudocysts was increased during further 5 and 10 days in vitro culture. CAMP stimulated the growth of bradyzoltes when in uiuo 3 and 5 days and then in vitro 5 and 10 days conditions were applied. In case of.DHFR Inhibitors, pynmethamlne produced a linearly decremental effect with a cont.-dependent mode but methotrexate was not effective against Intracellular bradyzoltes or pseudocysts In this system. It was suggested that cyst-forming strain of T gondii (ME49 strain) could be maintained and cultivated in uitro by use of murine peritoneal macrophages. In uivo 3 and 5 days and then in uiko 5 and 10 days conditions appeared to be suitable for culturing of bradyzoltes. CAMP and pyrimethamine had an effect of stimulation and inhibition on the growth of bradyzolte, respectively.

• Journal of fish pathology
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• v.4 no.2
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• pp.87-94
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• 1991

In the late summer of 1990 and 1991, mass mortality occured among cage-cultured grouper, Epinephelus septemfasciatus in south cost of Korea. The moribund fish didn't feed and became pale or dark chestnut colour and irregularly swimmed due to the loss of equilibrium, finally the diseased fish fell down side away on the bottom or the surface of cage showing the bent of body and died. The diseased fish showed the extensive hemorrahge in brain, the swelling of spleen and bile duct as the specific syptoms of internal organs. So the gill, skin and other organs of the diseased fish were examined for the presence of pathogenic parasites and bacteria. The parasitic Trichodina sp. were detected only from the gill lamella of the diseased fish, but these parasites seemed to be not a direct causative agents that induced the gross mortality of the cultured grouper. because these parasites were also observed in normal grouper, yellowtail, red seabream and rock bream co-cultured with the diseased grouper in same or near cages. In the viral examination, although isolation of the causative agent by the use of estabilshed cell Lines, RTG-2 and CHSE-214, was not succeed, the normal grouper inoculated intramuscularly with the filtered homogenate of the organs of the diseased fish showed the same external and internal signs with the naturally infected grouper. They died within a week. By using the naturally and the artificially infected fishes, electron microscopic observation revealed numerous hexagonal or polygonal particles in the cytoplasm of liver cells. Based on the these results, we suggest that the mass mortality of the cultured grouper would be occurred by the infection of a viral agent.

• Journal of Chest Surgery
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• v.31 no.10
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• pp.1004-1008
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• 1998

We report a case of heart-lung transplantation in a 32 year-old female with Eisenmenger syndrome secondary to patent ductus arteriosus. She has been suffered from congestive heart failure since June 1996 and repeatedly treated at Intensive Care Unit with intravenous inotropic support since July 1997. Preoperative echocardiography showed a patent ductus arteriosus with right to left shunt, severe regurgitation of tricuspid valve and estimated right ventricular systolic pressure of 100mmHg. The brain-dead donor was an 18 year-old male with head trauma from traffic accident 3 days ago. Heart-lung block procurement was performed at another general hospital and was transported to the Seoul National University Hospital by ambulance. Total ischemic time of the transplanted heart and lung were 249 minutes and 270 minutes, respectively. The immunosuppressive therapy was commenced preoperatively with cyclosporine and azathioprine. Corticosteroid was not used until postoperative 3 weeks in order to avoid infection and delayed healing at the tracheal anastomotic site. The patient was discharged at 31st postoperative day, and has been regularly followed up at outpatient clinic without specific complication. The follow-up bronchoscopy, performed 2 weeks and 4 months after surgery, revealed no evidence of cellular rejection.