Malaria is a febrile disease caused by protozoan parasites, genus Plasmodium. In Korea., indigenous malaria has been believed to be eradicated by 1984, and, thereafter, all of the reported cases were imported malaria. But since the first case report of re-emerging indigenous malaria in 1993, increasing number of cases were reported reaching more than 350 cases in 1996. However, indigenous malaria in children has not been reported yet. We experienced two cases of indigenous malaria in sisters who were 7 and 5 years old, respectively. Elder sister was presented with periodic fever, splenomegaly and mild headache. She had been to Guam before 4 months of the onset of symptoms. Younger sister was suffered from fever and splenomegaly and has not been abroad. They were diagnosed by examination of peripheral blood smear to be infected with Plasmodium vivax and were treated with hydroxychloroquine and primaquine successfully. These cases are believed to be first re-emerging cases of indigenous malaria in children, and malaria should be included in the differential diagnosis of unexplained febrile children.
The purposes of this study were to Identify the .level of measurement on quality Indicators and evaluate the existing indicators in order to determine the priority of quality indicators' application in Korean general hospitals. A survey was conducted using a questionnaire. The subjects were quality managers working at general hospital having over 300 beds. The criteria were relevance, reliability, precision, impact, application, and preference to evaluate quality indicators. According to these six criteria, each indicator was evaluated on a five point scale(5: excellent, 1: poor). The response rate was $40.4\%$. The hospitals have monitored the average of 3.8 indicators(median 4). The indicators such as return to operating room, unplanned readmission, cancellation of booked operations, death, hospital infection, cesarean section rate, volume per disease or procedure, readmission, re-operation, blood transfusion, and post-procedural complications were frequently measured. The top ten quality indicators in the evaluation by its relevance, validity, reliability, impact, preference and application were decubitus ulcer, clean wound infection, fall, unplanned return to operation room, transfusion reactions, foreign body left In during procedure, unplanned readmission, wound infection after contaminated surgery, postoperative hemorrhage/hematoma, and cesarean section rate in order. The high priority quality indicators frequently measured could be used as primary national indicators. Standardized guidelines about monitoring indicators and the utilization will preliminarily be needed to compare and reuse the data for various purposes and improve the quality of care continuously.
Meyer J. Friedman;Haram Lee;Young-Chan Kwon;Soohwan Oh
Journal of Microbiology and Biotechnology
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제32권12호
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pp.1515-1526
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2022
Eukaryotic chromatin is highly organized in the 3D nuclear space and dynamically regulated in response to environmental stimuli. This genomic organization is arranged in a hierarchical fashion to support various cellular functions, including transcriptional regulation of gene expression. Like other host cellular mechanisms, viral pathogens utilize and modulate host chromatin architecture and its regulatory machinery to control features of their life cycle, such as lytic versus latent status. Combined with previous research focusing on individual loci, recent global genomic studies employing conformational assays coupled with high-throughput sequencing technology have informed models for host and, in some cases, viral 3D chromosomal structure re-organization during infection and the contribution of these alterations to virus-mediated diseases. Here, we review recent discoveries and progress in host and viral chromatin structural dynamics during infection, focusing on a subset of DNA (human herpesviruses and HPV) as well as RNA (HIV, influenza virus and SARS-CoV-2) viruses. An understanding of how host and viral genomic structure affect gene expression in both contexts and ultimately viral pathogenesis can facilitate the development of novel therapeutic strategies.
Purpose: As communicable disease, COVID-19, pandemic strikes over the world, it is critically bewared that air travel possibly be a major pass way to deliver the infectious disease virus. Especially the airplane could be an unique environment to cultivate the virus spreaders. In order to keep the continuous safe airway as well as the industry, related international associations and organizations have been published the guidelines for the prevention and control the infectious disease through the all aspects of aviation. By reviewing the guidelines, focusing on the in-flight infection prevention and control, this study would not only inform a summary of the international guidelines but also provide an essential and general consideration for related research or guideline study. Methods: Guidelines of 5 major countries are reviewed, which has been seriously influenced by COVID-19 : U.S., Canada, E.U., Australia and China. The items of the guidelines are re-categorized as its similarity and structure by applicable cases. Results: The result of this study shows that each guideline seems to share a major structure and issue such as identifying sick traveler, sick passenger care, and cleaning even though that of China has a different since it used to consider the flight conditions based on 3 levels of infection risk. For sick passenger care, the guidelines includes crew safety, service level, sick passenger isolation, and cleaning. Implications: A published guideline as a public manual could be to prevent and control the in-flight infection efficiently and promptly. It also could provide a confidence of knowledge and educate for all users to prepare the in-flight emergency as well.
Bae, Sung Kyu;Kang, Seok Joo;Kim, Jin Woo;Kim, Young Hwan;Sun, Hook
Archives of Plastic Surgery
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제40권1호
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pp.28-35
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2013
Background If a chronically infected abdominal wound develops, complications such as peritonitis and an abdominal wall defect could occur. This could prolong the patient's hospital stay and increase the possibility of re-operation or another infection as well. For this reason, a solution for infection control is necessary. In this study, surgery using a rectus abdominis muscle myofascial splitting flap was performed on an abdominal wall defect. Methods From 2009 to 2012, 5 patients who underwent surgery due to ovarian rupture, cesarean section, or uterine myoma were chosen. In each case, during the first week after operation, the wound showed signs of infection. Surgery was chosen because the wounds did not resolve with dressing. Debridement was performed along the previous operation wound and dissection of the skin was performed to separate the skin and subcutaneous tissue from the attenuated rectus muscle and Scarpa's fascial layers. Once the anterior rectus sheath and muscle were adequately mobilized, the fascia and muscle flap were advanced medially so that the skin defect could be covered for reconstruction. Results Upon 3-week follow-up after a rectus abdominis myofascial splitting flap operation, no major complication occurred. In addition, all of the patients showed satisfaction in terms of function and esthetics at 3 to 6 months post-surgery. Conclusions Using a rectus abdominis myofascial splitting flap has many esthetic and functional benefits over previous methods of abdominal defect treatment, and notably, it enabled infection control by reconstruction using muscle.
Enteroaggregative E. coil (EAEC) is an important aethiological causal agent of diarrhea in people of developed and undeveloped countries. Different in vitro and in vivo models have been proposed to study the pathdgenic and immune mechanisms of EAEC infaction. The aim of this study was to analyze whether BALB/c mice could be used as an animal model to study EAEC pathogenesis Six-week-old BALB/c mice were inoculated with EAEC strain 042 (044:H88) nalidixic acid resistant, and re-inoc-ulated ten days after. Mice feces were monitored for the presence of the EAEC strain over a period of 20 days . Bacteria were enumerated on MacConkey agar containing 100$\mu$g of nalidixic acid per ml. Results showed that 35% of the animals were colonized for 3 days, 15% for 5 and 10% for more than 7 days . After re-inoculation only 16% of the animals remained colonized for more than 3 days. During the necropsy, the intestinal fluid of same of the infected animals presented mucus and blood. Six of these fluids showed the presence of IgA antibodies againset Pet toxin and IgG natibodies raised against the toxin were also detected in the animal serum. Histopathologic evidence confirms the stimulation of mucus hypersecretion, an increased amount of goblet cells and the presence of bacterial aggregates in the apical surfaces of intestinal epithelial cells. Edema was present in the submucosa. These results suggest that BALB/c mice could be used as an animal model for in vivo study of EAEC infection.
A re-pull-through operation for Hirschsprung's disease is performed when the primary operation has failed because of the remnant or acquired aganglionosis, anastomotic stricture and/or fistula. The purpose of this study is to review our experience of the re-pull-through procedure for Hirschsprung's disease. From May 1978 to July 2003, 26 patients who underwent re-pull-through operations at the Department of Pediatric Surgery, Seoul National University Children's Hospital, were studied retrospectively by means of chart review as well as telephone interview. The mean age at primary operation and re-operation were llmonths (2 months - 10 years) and 43 months (1 year - 23 years 3 months), respectively. Initial operation for Hirschsprung's disease was Duhamel's procedure in 17, Swenson's in 6 and Soave's 3. Causes of failure of primary operation were remains of secondary aganglionic segment (n=23), vascular arcade injury (n= 1), rectoperineal fistula (n=2, due to mesenteric torsion and poor blood supply), Mean interval between the primary operation and the re-operation was 34 months (6 months-22 years). Reoperation methods were Soave's in 12, Duhamel's in 8, APSP (abdomino-posterosagittal pull-through procedure) in 5, and Swenson's in 1 case. In 2 cases of repeated rectoperineal fistula or rectourethral fistula, re-APSP were performed 3 times, respectively. A total of 29 re-pull-through operations were performed. Postoperative complications were wound infection (n=1), adhesive ileus (n=1), rectoperineal fistula (n=3), rectourethral fistula (n=2), and death due to pulmonary embolism (n=1). Mean follow up period of reoperation was 78 months (1 month-23years). In current state, 2 patients have an ileostomy because of repeated rectoperineal fistula and rectourethral fistula. Of the remaining 23 patients, 21(91 %) are totally continent with or without minimal soiling. Reoperation for Hirschsprung's disease was effective and safe for the patients complicated to the initial pull-through operation.
Effect of raising types and environmental conditions on the infection of Toxoplasma in the swine, the cat and the man were studied in Cheju Island from Sept. 1987 to Aug. 1988. Blood samples were taken from 214 conventionally raised swine in 6 villages and 506 swine raised in swine specialized farms, 122 cats raised under free moving or restraned conditions in 8 locations, 113 butchers, and 210 villagers. Toxoplasma antibody values of the blood sera were determined using the enzymelinked immunosorbent assay (ELISA). The eating type of viscera was also investigated by using questionaires 1. When ELISA method was used, the percentage of Toxoplasma infected swine among the conventionally raised and of those raised in swine specialized farms were 60.7% and 21. 390, respectively. The respective mean of antibody values (${\pm}SD$) were 0.589 (${\pm}0.310$) and 0.385 (${\pm}0.237$) and differed very significantly (p<0.01). A significant difference was also found in antibody values among 6 villages (p<0.05). 2. The mean infection percentage of toxoplasma in the cat was 38.2%. the infection percentage for cats raised under free-moving and re~;trained condition were 37.0% and 38.2% respectively. The respective antibody values(${\pm}SD$) for toxoplasma were 0.600(${\pm}0.614$) and 0.637 (0.645), and did not difference significantly. 3. The infection percentage of toxoplasma in villagers and butchers were 26.2 and 38.3% respectively. The respective antibody values (SD) for toxoplasma were 0.429(${\pm}0.195$) and 0.341 (${\pm}0.236$), and differed very significantly (p<0.01). There were also highly significant differences Pyo-sun and other village (p<0.01). 4. Analysis of the questionaires showed that 26.0% of 392 villages eated liver and some villagers eated other viscera.
Han, Song Yi;Lee, I Re;Park, Se Jin;Kim, Ji Hong;Shin, Jae Il
Clinical and Experimental Pediatrics
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제59권3호
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pp.139-144
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2016
Purpose: Acute pyelonephritis (APN) is a serious bacterial infection that can cause renal scarring in children. Early identification of APN is critical to improve treatment outcomes. The neutrophil-lymphocyte ratio (NLR) is a prognostic marker of many diseases, but it has not yet been established in urinary tract infection (UTI). The aim of this study was to determine whether NLR is a useful marker to predict APN or vesicoureteral reflux (VUR). Methods: We retrospectively evaluated 298 pediatric patients ($age{\leq}36months$) with febrile UTI from January 2010 to December 2014. Conventional infection markers (white blood cell [WBC] count, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP]), and NLR were measured. Results: WBC, CRP, ESR, and NLR were higher in APN than in lower UTI (P<0.001). Multiple logistic regression analyses showed that NLR was a predictive factor for positive dimercaptosuccinic acid (DMSA) defects (P<0.001). The area under the receiver operating characteristic (ROC) curve was high for NLR (P<0.001) as well as CRP (P<0.001) for prediction of DMSA defects. NLR showed the highest area under the ROC curve for diagnosis of VUR (P<0.001). Conclusion: NLR can be used as a diagnostic marker of APN with DMSA defect, showing better results than those of conventional markers for VUR prediction.
Like the other herpesviruses, the virion of MDV consists of an envelope, which surrounds an amorphous tegument. Within the tegument, and icosahedral capsid encloses a linear double-stranded DNA core. Although the genome structure of MDV indicates that it is an ${\alpha}-herpesvirus$ like herpes simplex and varicella-zoster viruses, biological properties indicate MDV is more akin to the ${\gamma}-herpesvirus$ group, which includes Epstein-Barr and Kaposi's sarcoma herpesviruses. These herpesviruses replicate lytically in lymphocytes, epithelial and fibroblastic cells, and persist in lymphoblastoid cells. MDV has a complex life cycle and uses two means of replication, productive and non-productive, to exist and propagate. The method of reproduction changes according to a defined pattern depending on changes in virus-cell interactions at different stages of the disease, and in different tissues. Productive (lytic) interactions involve active invasion and take-over of the host cell, resulting in the production of infectious progeny virions. However, some herpesviruses, including MDV, can also establish a non-productive (abortive) infection in certain cell types, resulting in production of cell-associated progeny virus. Non-productive interactions represent persistent infection, in which the viral genome is present but gene expression is limited, there is no structural or regulatory gene translation, no replication, no release of progeny virions and no cell death. Reactivation of the virus is rare, and usually the infectious virus can be re-isolated only after cultivation in vitro. MDV establishes latency in lymphoid cells, some of which are subsequently transformed. In this review article, recent knowledges of the pathogenesis mechanisms followed by MDV infection to sensitive cells and chickens are discussed precisely.
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