• Journal of Environmental Health Sciences
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• v.45 no.5
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• pp.434-442
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• 2019

Objectives: This study was performed in order to report the epidemiological features of a food poisoning outbreak caused by multiple pathogens in a high school in Chungcheongnam-do Province, Korea in April 2019 and to suggest measures to prevent a similar incidence. Methods: A total of 39 patients with diarrhea were examined. Environmental samples were obtained from 6 food handlers, 4 food utensils, 72 preserved foods served during the food poisoning outbreak, 9 door handles, 10 drinking water samples from water dispensers, and 6 ground water samples from water taps. These analyzed to detect viruses and bacteria. Results: Among the 39 patients, 21 cases (53.8%) of enteroaggregative E. coli (EAEC), 7 cases of Staphylococcus aureus (17.9%), and 17 cases of norovirus (43.6%) were positive, and in 16 of the cases a co-infection with at least one other pathogen were observed. EAEC was assumed to be transmitted from contaminated drinking water because it was also detected in the water sample from a water dispenser in the dormitory. Staphylococcus aureus was isolated only in the fecal samples of patients, meaning it was not possible to trace its origin. The genotype of norovirus detected in the drinking water and ground water was consistent with that isolated from patients, and it was determined that the norovirus infection originated from the school's water environment. Conclusions: These findings indicate that a lack of environmental hygiene management related to school meals caused the food poisoning incident. In particular, a lack of management of drinking water, water supply, and personal hygiene should be pointed out. This should be urgently addressed and continuous monitoring should be carried out in the future. In addition, students and staff should be educated and trained to improve their personal hygiene.

• Korean Journal of Clinical Laboratory Science
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• v.51 no.3
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• pp.294-300
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• 2019

To investigate the inhibition effect on pathogenic microbes and the antimicrobial resistance of probiotics, a total of 140 probiotics were isolated from 35 kinds of Korean commercially available Kimchi. Of those, L. plantarum was identified from 53 strains (37.9%), E. faecium from 27 strains (19.3%), and L. rhamnosus from 7 strains (5.0%) using 16S rRNA gene sequencing. Sixty nine strains (49.3%) showed overall antimicrobial activity against pathogenic microbes, namely S. Typhi, S. Enteritidis, E. coli O157:H7, S. flexneri, NAG Vibrio, Listeria monocytogenesis, Y. enterocolitica, S. aureus, S. pyogenes, G. vaginalis, C. albicans, and P. acne. The proportions of L. plantarum, E. faecium, and L. rhamnosus strains to pathogenic microbes were 75.5%, 40.7%, and 28.6%, respectively. In addition, a resistance test with 18 antimicrobial agents using a disk diffusion assay revealed a resistance incidence of 98.6% for nalidixic acid, 83.6% for streptomycin, 75.7% for gentamicin 73.6% for vancomycin, 72.1% for norfloxacin, and 67.9% for ciprofloxacin. In conclusion, L. plantarum, L. sakei, and E. faecium strains with various antimicrobial activities and broad antibiotic resistance are useful for treating diarrhea in long-term inpatients and for the alternative use for treating Candida species female vaginitis.

• Animal Bioscience
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• v.34 no.12
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• pp.1963-1973
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• 2021

Objective: The present study aimed to evaluate the influence of including L-glutamine along with glutamic acid as a supplement in weaned piglets' diets with and without whey powder. Methods: Two assays were carried out. A total of 40 piglets ([Landrace×Large White]×Pietrain) weaned at 24 days of age with an initial body weight of 6.6±0.6 kg were used in the first assay, and the following parameters were evaluated: growth performance, the incidence of diarrhea, morphometry, intestinal integrity, and hepatic glycogen index. The animals were then blocked into four groups according to different diets: diet all-grain feeding (G); diet all-grain feeding with whey powder (GW); and with vs without 1% supplementation of the commercial product containing L-glutamine and glutamic acid (A or NA). Whey powder was added according to the stage of life, corresponding to 17%, 10%, and 5%, respectively, in order to meet the need for lactose. The animals were evaluated at 24 to 42 days and at 24 to 55 days of age. The nutrient digestibility for the second assay was carried out by using 24 animals with an average weight of 11.49±1.6 kg, and the same diets were tested. Results: The supplementation of L-glutamine + glutamic acid or the addition of whey powder in diets for weaned piglets provided (p<0.05) greater feed intake, greater weight gain and improved feed conversion in the initial period (24 to 42 days age). However, in the whole period (24 to 55 days age) only amino acid supplementation affected (p<0.05) growth performance. There was a positive interaction (p<0.05) between the type of diet and L-glutamine + glutamic acid supplementation on villus height, crypt depth and the villus:crypt ratio in the duodenum. In addition, L-glutamine + glutamic acid supplementation reduced (p<0.05) the crypt depth and improved the villus:crypt ratio in the jejunum. The inclusion of whey powder affected (p<0.05) positively the digestibility coefficients analyzed except mineral matter digestibility coeficients. The supplementation of 1% the commercial product composed of L-glutamine and glutamic acid improved (p<0.05) only the digestibility coefficient of crude protein. Conclusion: These results indicate that supplementation of 1% commercial product containing L-glutamine + glutamic acid in diets for piglets from 24 to 55 days of age, dispenses with the use of whey powder when evaluating growth performance. Amino acid supplementation alone or associated with whey powder affects (p<0.05) positively the indicators of the intestinal integrity.

• Animal Bioscience
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• v.36 no.4
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• pp.642-653
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• 2023

Objective: This study was conducted to evaluate effects of β-glucan with vitamin E supplementation on the growth performance, blood profiles, immune response, fecal microbiota, fecal score, and nutrient digestibility in weaning pigs. Methods: A total of 200 weaning pigs with an average body weight (BW) of 7.64±0.741 kg were allotted to five treatment groups and were divided based on sex and initial BW in four replicates with ten pigs per pen in a randomized complete block design. The experimental diets included a corn-soybean meal-based basal diet with or without 0.1% or 0.2% β-glucan and 0.02% vitamin E. The pigs were fed the diets for 6 weeks. A total of 15 barrows were used to evaluate the nutrient digestibility by the total collection method. The BW and feed intake were measured at the end of each phase. Blood samples were collected at the end of each phase, and fecal samples were collected at the end of the experiment. Results: The addition of β-glucan with vitamin E to weaning pig feed increased BW, average daily gain, and average daily feed intake. A significant decrease in yeast and mold and Proteobacteria and a tendency for Lactobacillus to increase compared to the control was shown when 0.1% β-glucan and 0.02% vitamin E were added. The fecal score in weaning pigs was lower in the treatments supplemented with 0.1% or 0.2% β-glucan and 0.02% vitamin E compared to the control. In addition, vitamin E was better supplied to weaning pigs by increasing the concentration of α-tocopherol in the blood of weaning pigs when 0.02% vitamin E was supplemented. However, there was no significant difference in either the immune response or nutrient digestibility. Conclusion: Inclusion of 0.1% β-Glucan with 0.02% vitamin E in a weaning pig's diet were beneficial to the growth performance of weaning pigs by improving intestinal microbiota and reducing the incidence of diarrhea.

• Clinical and Experimental Pediatrics
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• v.48 no.1
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• pp.63-67
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• 2005

Purpose : Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP) is a systemic vasculitis, characterized by cutaneous palpable purpura, gastrointestinal(GI) symptoms, arthritis and renal involvement. In general, the prognosis is determined by GI complication as well as the severity of nephritis. In this study, we analyzed the statistical relationship between the GI symptom and other clinical findings for assessing the prognosis, and evaluated abdominal ultrasonographic findings for early diagnosis of this disease with atypical clinical presentation and early detection of serious GI complications. Methods : One hundred seventy seven patients with HSP in the Department of Pediatrics, Wonkwang University Hospital from January 1994 to June 2004, were enrolled. We retrospectively analyzed charts about clinical and abdominal ultrasonographic findings, and classified our patients into two groups(GI-Sx(-), GI-Sx(+)) for statistical analysis. Results : The ratio of female to male is 1.5 : 1. The peak age incidence was five to eight years in 95 cases(53%). The GI symptoms appeared in 117 cases(66%), which include abdominal pain 115 (98 %), tenderness 45(38%), nausea and vomiting 35(30%), bloody stool 10(8.5%), diarrhea four(3.4%), rebound tenderness four(3.4%), and also intussusception and appendicitis were complicated in five and two cases respectively. GI-Sx(+) group had an increased risk of renal involvement and relapse than the GI-Sx(-) group. But there were no relationships about sex and age incidence, or other clinical and laboratory findings between two groups. Ultrasonographic findings in 98 patients with GI symptoms included small bowel thickening in 70 cases(71%) in which duodenum, jejunum and ileum were involved in 71%, 45.7%, 40% respectively, small bowel dilatation in 41 cases(42%), lymph node swelling in 46 cases(47%), and ascites in 25 cases(25.5%). Conclusion : GI symptoms in patients with HSP suggested increased risk of renal involvement and relapse. Abdominal ultrasonography could be helpful in the early diagnosis on atypical clinical presentation and early detection of serious GI complication in these patients.

• Neonatal Medicine
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• v.16 no.1
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• pp.55-63
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• 2009

Purpose: This study was conducted to investigate the incidence and clinical manifestations of rotaviral infections in the neonatal intensive care unit (NICU). We also investigated whether neonates referred from other hospitals cause outbreaks of rotaviral infections in the NICU. Methods: Neonates diagnosed wit rotaviral infections in the NICU at Korea University Ansan Hospital between January 2002 and December 2006 were evaluated retrospectively. Results: Of 1,501 neonates admitted to the NICU, the number of rotaviral infections was 94 (6.3%) and the prevalence was 4.9 cases per 1,000-hospital days. Of 223 neonates referred from other hospitals to our NICU, 24 (10.8%) were confirmed to have rotaviral infections at the time of referral. Common symptoms of rotaviral infections were jaundice diarrhea or loose stools, vomiting, fever, apnea, irritability, seizures, and moaning sounds. Necrotizing enterocolitis of stage II or more was diagnosed in 3 premature neonates, accounting for 3.2% of total infected neonates and 6.8% of premature infected patients. There were no statistically significant differences in the prevalence of symptoms between term and preterm neonates, except for jaundice that is more frequent in premature infants. In time series analysis, the admission of neonates who were born at other hospitals and diagnosed with rotaviral infections were associated 1 month later by increased cases of neonates with rotaviral infections who were born at our hospital, whereas new cases of rotaviral infections among inborn neonates were decreased 2 and 4 months later (P<0.05). Conclusion: Rotaviral infections in NICU were not rare and showed vague symptoms. Three cases (3.2%) were diagnosed with stage II or more necrotizing enterocolitis. The referred neonates with rotaviral infections may induce outbreaks in the NICU, therefore awareness and strict surveillance for rotaviral infections should be performed at the time of referral.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.13 no.2
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• pp.146-153
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• 2010

Purpose: Recent studies have reported an increase in the incidence of community-acquired Clostridium difficile-associated disease (CA-CDAD) among children. There is an overall lack of information on CA-CDAD in the pediatric population. The aim of our study was to compare the epidemiologic and clinical features between CA-CDAD and hospital-acquired C. difficile-associated disease (HA-CDAD) in children. Methods: We retrospectively reviewed the medical records of all patients who were diagnosed with C. difficile-associated disease (CDAD) at Gil Hospital between April 2008 and March 2009. The diagnosis of CDAD was made when patients with gastrointestinal symptoms had positive results for C. difficile toxins A and B assay or stool culture. Results: Sixty-one (male, 32 and female, 29) patients were included. The mean age was 3.79${\pm}$4.54 years. Of the 61 patients, 22 (36.1%) were <1 year of age. Twenty-three patients (37.7%) had a history of antibiotic exposure in the previous 3 months. Forty-one patients (67.2%) were diagnosed with CA-CDAD. There were no significant differences in age, gender, symptoms, laboratory findings, recovery period, complications, and recurrence between the CA-CDAD and HA-CDAD groups. On the other hand, exposure to antibiotics was significantly more frequent among patients in the HA-CDAD group (p=0.005). Conclusion: This study suggests that the occurrence of CA-CDAD is increasing in the pediatric population, especially in younger children with no history of exposure to antibiotics and in outpatients. Awareness of the increasing incidence of CA-CDAD and prompt investigation of C. difficile in susceptible patients is needed to avoid misdiagnosis and for appropriate therapy.

• Pediatric Infection and Vaccine
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• v.7 no.2
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• pp.211-217
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• 2000

Purpose : Salmonellosis including typhoid fever is still prevalent in Korea. Recently it has been reported that the incidence of salmonella gastroenteritis is increasing with a reduction of typhoid fever. We studied the clinical and laboratory features of salmonellosis. Methods : We evaluated the clinical records of 83 patients with salmonellosis who had been confirmed by stool culture from 1994 to 1999. Results : Annual incidence of salmonellosis showed an increasing tendency during recent 4 years. Seasonally, summer(45.8%) was the most prevalent, followed by fall(32.5%). Male to female ratio was 1.4 : 1. In age distribution, 64 cases(77.1%) were under 5 year-old, and 18 cases(21.7%) were younger than 1 year-old. Clinical features included diarrhea(96.4%), fever(91.6%), vomiting(49.4%), bloody stool(42.1%), abdominal pain(40.1%) and tenesmus(12.0%). In serogroups, there was no group A and group B, group C, group D(including 2 cases of S.typhi) and group E were in 41.0%(34 cases), 3.6%(3 csaes), 51.8%(43cases) and 3.6%(3 cases), respectively. In Widal test, 5 cases(13.5%) and 1 case(2.7%) of group B, C and E(total 37 cases) were observed the O titer above 1 : 80 and 1 : 320, respectively. However, in 36 cases of group D, 19 cases(52.7%) and 9 cases(25.0%) were above the O titer 1 : 80 and 1 : 320, respectively. Antibiotics resistant rates to ampicillin, trimethoprim/sulfamethoxazole and chloramphenicol were 23.2%, 10.1% and 51.4%, respectively. Conclusion : Salmonellosis has become a common cause of gastroenteritis in children, especially under the pre-school age. Isolation of salmonella is neccessary for accurate diagnosis of gastroenteritis and typhoid fever. A careful attention of the use of antibiotics is needed to reduce the muilti-drug resistant strains.

• Radiation Oncology Journal
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• v.18 no.1
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• pp.17-25
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• 2000

Purpose : To evaluate the side effects, pattern of failure, and survival rate according to the sequence of postoperative adjuvant radiotherapy and chemotherapy, patients with stages II and III rectal cancer who had undergone curative resection were randomized to 'early radiotherapy group (arm I)' or' late radiotherapy group (arm II)', then we intend to determine the most effective sequence of the radiotherapy and chemotherapy. Materials and Methods . From January 1996 to March 1999, 313 patients with curatively resected stages II and III rectal cancer have been randomized to' early' or' late' radiation therapy group and received combined chemotherapy (5-FU 375 mg/m$^{2}$/day, ieucovorin 20 mg/m$^{2}$, IV bolus daily Dl-5, 8 cycles) and radiation therapy (whole pelvis with 45 Gy/25 fractions/s weeks). Arm I received radiation therapy from day 1 with first cycle of chemotherapy and arm II received radiation therapy from day 57 with third cycle of chemotherapy after completion of first two cycles. Preliminary analysis was peformed with 228 patients registered up to Jun 1998. Two out of the 228 patients were excluded because of double primary cancer. Median follow-up period was 23 months. Results :Local recurrence occurred in 11 patients (9.7$\%$) for arm I and 9 patients (8$\%$) for arm 11. There was no significant difference between both groups ( p=0.64). However, distant metastasis was found in 22 patients (19.5$\%$) for arm I and 35 patients (31.0$\%$) for arm II and which showed statistically significant difference between the two groups ( p=0.046). And neither 3-year disease-free survival (70.2$\%$ vs 59.2$\%$, p=0.2) nor overall survival (89.4$\%$ vs 88.0$\%$, p=0.47) showed significant differences. The incidence of leukopenia during radiation therapy and chemotherapy was 78.3$\%$ and 79.9$\%$ respectively but leukopenia more than RTOG grade 3 was only 2.1$\%$ and 6.0$\%$ respectively. The incidence of diarrhea more than 10 times per day was significantly higher in the patients for arm I than for arm II (71.2$\%$ vs 41.6$\%$, p=0.02) but this complication was controlled with supportive cares. Conclusion : Regardless of the sequence of postoperative adjuvant radiation therapy and chemotherapy after curative resection for rectal cancer, local recurrence rate was low with combined chemoradlotherapy. But distant metastasis rate was lower in early radiation therapy group than in late radiation therapy group and the reason is unclear. Most patients completed these treatments without severe complication, so these were thought to be safe treatments but the treatment compliance should be improved.

• Journal of Animal Science and Technology
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• v.45 no.6
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• pp.1079-1088
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• 2003

This study was conducted to test the efficacy of the automatic liquid feeder(designated as NLRI) developed by National Livestock Research Institute, Korea for 7-day old early-weaning piglets. The other automatic liquid feeder imported from USA(designated as IALF) was used for a comparative purpose. A total of sixty piglets of 7 days of age were allotted to three treatments. The control group of 20 piglets was raised by their own sows until 21 days of age, while others were shifted to automatic liquid feeders of either NLRI or IALF on 7 days of age and reared during 14 days post-weaning. After then, all the piglets were fed nutritionally identical mash diets until 70 days of age. Compared with control group, body weight of piglets reared on automatic liquid feeders were lighter(P〈0.05) at 21 days of age [5.55kg (control) vs 4.97 (NLRI) and 4.98kg (IALF)], while heavier(P〈0.05) at 70 days of age(24.82kg vs 30.17 and 29.42kg). The results indicated that pigs reared on liquid feeding showed higher(P〈0.05) average daily gain than control pigs during the whole experimental period [346.7g (control) vs 425.8 (NLRI) and 416.1g (IALF)], while no difference was found in feed/gain (1.67 vs 1.78 and 1.84). There was no difference in growth performance and incidence of diarrhea between two automatic liquid feeders, NLRI and IALF. Compared with control group, intestinal villi tended to be shorter in liquid feeding group during the first week, but were recovered within two weeks. The results suggest that the automatic liquid feeder newly developed by National Livestock Research Institute, Korea can be successfully used for rearing young piglets weaned at very early age.