Generation and protective efficacy of a cold-adapted attenuated genotype 2b porcine epidemic diarrhea virus

The recent emergence and re-emergence of porcine epidemic diarrhea virus (PEDV) underscore the urgent need for the development of novel, safe, and effective vaccines against the prevailing strain. In this study, we generated a cold-adapted live attenuated vaccine candidate (Aram-P29-CA) by short-term passage of a virulent PEDV isolate at successively lower temperatures in Vero cells. Whole genome sequencing identified 12 amino acid changes in the cold-adapted strain with no insertions and deletions throughout the genome. Animal inoculation experiments confirmed the attenuated phenotype of Aram-P29-CA virus in the natural host. Pregnant sows were orally administered P29-CA live vaccines two doses at 2-week intervals prior to parturition, and the newborn piglets were challenged with the parental virus. The oral homologous prime-boost vaccination of P29-CA significantly improved the survival rate of the piglets and notably mitigated the severity of diarrhea and PEDV fecal shedding after the challenge. Furthermore, strong antibody responses to PEDV were detected in the sera and colostrum of immunized sows and in the sera of their offspring. These results demonstrated that the cold-adapted attenuated virus can be used as a live vaccine in maternal vaccination strategies to provide durable lactogenic immunity and confer passive protection to litters against PEDV.

Acute porcine reproductive and respiratory syndrome outbreaksin immunized sow herds: from occurrence to stabilization under whole herd vaccination strategy

Outbreaks of porcine reproductive and respiratory syndrome virus (PRRSV) in vaccinated sow herds from occurrence to stabilization were monitored and analyzed in terms of serology and reproductive performance. Three different conventional pig farms experienced severe reproductive failures with the introduction of a type 1 PRRSV. These farms had adopted mass vaccination of sows using a type 2 PRRSV modified live vaccine (MLV). Therefore, to control the type 1 PRRSV, an alternative vaccination program utilizing both type 1 and type 2 MLV was undertaken. Following whole herd vaccinations with both types of MLV, successful stabilization of PRRS outbreaks was identified based on serological data (no viremia and downward trends in ELISA antibody titers in both sows and suckling piglets) and recovery of reproductive performance. Additionally, through comparison of the reproductive parameters between outbreak and non-outbreak periods, it was identified that PRRSV significantly affected the farrowing rate and the number of suckling piglets per litter at all three pig farms. Comparison of reproductive parameters between periods when the different vaccination strategies were applied revealed that the number of piglets born in total and born dead per litter were significantly increased after the introduction of the type 1 PRRS MLV.

Acute porcine reproductive and respiratory syndrome outbreaksin immunized sow herds: from occurrence to stabilization under whole herd vaccination strategy / 대한수의학회지

Outbreaks of porcine reproductive and respiratory syndrome virus (PRRSV) in vaccinated sow herds from occurrence to stabilization were monitored and analyzed in terms of serology and reproductive performance. Three different conventional pig farms experienced severe reproductive failures with the introduction of a type 1 PRRSV. These farms had adopted mass vaccination of sows using a type 2 PRRSV modified live vaccine (MLV). Therefore, to control the type 1 PRRSV, an alternative vaccination program utilizing both type 1 and type 2 MLV was undertaken. Following whole herd vaccinations with both types of MLV, successful stabilization of PRRS outbreaks was identified based on serological data (no viremia and downward trends in ELISA antibody titers in both sows and suckling piglets) and recovery of reproductive performance. Additionally, through comparison of the reproductive parameters between outbreak and non-outbreak periods, it was identified that PRRSV significantly affected the farrowing rate and the number of suckling piglets per litter at all three pig farms. Comparison of reproductive parameters between periods when the different vaccination strategies were applied revealed that the number of piglets born in total and born dead per litter were significantly increased after the introduction of the type 1 PRRS MLV.

Genetic identification and serological evaluation of commercial inactivated foot-and-mouth disease virus vaccine in pigs

Vaccination is considered a frequently used tool to prevent and control foot-and-mouth disease (FMD). However, the effectiveness of conventional FMD virus (FMDV) vaccines in pigs has been controversial because the massive prophylactic vaccination could not elicit proper immune response nor prevent the broad spread of FMD outbreak, mainly in pig farms, in South Korea during outbreaks of 2014. In addition, there has been little information on the efficacy of inactivated, high potency, multivalent, oil-based FMDV vaccine in pigs, because an evaluation of FMDV vaccines had been mainly carried out using cattle. In this study, we evaluated the genetic identification of commercial inactivated FMDV vaccine and monitored the immune responses in pigs under the field condition. Results implied that it contained three different serotypes with a high level of antigen payload. However, serological results showed low mean percentage of inhibition, and positive rate reached its peak at 6-week post-vaccination, indicating current FMDV vaccine need to improve for a prophylactic vaccination policy in pigs. Therefore, there is an imperative need to develop FMDV vaccine that can provide rapid and long-lasting protective immunity in pigs.

VATER Syndrome: A Case Report

VATER syndrome is defined as the combinations of three or more of the followings; Vertebral defect, Anal atresia, Esophageal atresia and/or Tracheo-Esophageal fistula, Renal dysplasia, and Radial-ray limb anomalies. A 21-month old female patient was admitted. She had the history of anastomosis of trcheo-esophageal fistula, V-P shunt operation due to hydrocephalus, and spina bifida. Upon admission, physical examinations showed increased deep tendon reflexes of all four extremities with grade 1 spasticity and popliteal angle being 45 degrees, bilaterally. The overall development of the patient was delayed. The imaging study showed hydrocephalus, periventricular leukomalatic change, underdevelopment of the cerebral cortex, atrophy of corpus callosum, Arnold-Chiary malformation, a vascular malformation along the intradural space from lower cervical to nearly entire thoracic vertebral level, multiple vertebral anomalies, and the fusion of multiple ribs. Furthermore hydronephrosis of the left kidney was detected. Follow-up of natural history and management of the patient is needed.

Coexisting brenner tumor and struma ovarii in the unilateral ovary; A case report / 대한산부인과학회지

Co-existing Brenner tumor and struma ovarii in the unilateral ovary is very rare. The present case, which is the first case in Korea, and to our knowledge only nine cases had been reported in other countries. We report a case of 42-year-old woman who had co-existing Brenner tumor and struma ovarii in the unilateral ovary with a brief review of the literature.

Alteration of Circadian Diurnal Rhythms of Cardiovascular Parameters by Night Shift Work in 3 Shift Nurses

Background: There are incoherent studies about the effect of night shift work on circadian diurnal rhythms of cardiovascular parameters. Our study aimed to assess the alteration of circadian diurnal rhythms of cardiovascular parameters by night shift work. Methods: We studied 26 healthy nurse volunteers engaged in 3 shift work. From March 16 to April 30, 2006, ABPM (ambulatory blood pressure monitoring) was performed to each nurse two times during the day and night shift. Three nurses were excluded due to pain omdiced by ABPM. Blood pressure and heart rate was monitored every 30 minutes. Paired T-test was used for statistical analysis. Results: The mean arterial pressure, the mean systolic pressure, the mean heart rate and the mean pulse pressure during the overall period were significantly higher in the night shift than the day shift (P-value: <0.05, <0.001, <0.05, and <0.001, respectively). The mean arterial pressure, the mean diastolic pressure and the mean heart rate during in-hospital working period were significantly higher in the day shift (P-value: <0.05, <0.001, and <0.05, respectively). All parameters during the daytime sleep period after the night shift were significantly higher than during the nighttime sleep period after the day shift (P-values: <0.001). Proportional percentile falls of 3 parameters (systolic pressure, diastolic pressure, and heart rate) during the daytime sleep period after the night shift were significantly less than during the nighttime sleep period after the day shift (P-values: <0.001). Conclusion: The night shift work caused significant alteration in homeostasis of autonomic nervous system associated with circadian diurnal rhythms of cardiovascular parameters.

A case of malignant Brenner tumor developed at an ovary after contralateral oophorectomy / 부인종양

The Brenner tumors of the ovary are uncommon and constitute 1.5-2.5% of all ovarian neoplasms. And their malignant counterparts are rare. Although the first malignant Brenner tumor was described by Von Numers in 1945, only a few malignant Brenner tumors have been reported. The definition and its biologic behavior, and the optimal treatment has not been established. We present a patient who had total abdominal hysterectomy with unilateral salpingooophorectomy due to adenomyosis. The resected ovary had only follicular cysts and the remained ovary was grossly normal . Malignant Brenner tumor developed at the remained ovary 15 years after operation. Operation and adjuvant chemotherapy was applied and patient is alive without evidence of disease. We have experienced a case of malignant Brenner tumor developed at the remained ovary after contralateral oophorectomy with a brief review of literature.

Clinical Features of Ophthalmic Artery Hypoperfusion

PURPOSE: The purpose of the study is to investigate the clinical features and relation of systemic disease of ophthalmic artery hypoperfusion (OAH). METHODS: We reviewed the records of 20 eyes of 19 ophthalmic artery hypoperfusionpatients who were followed up for 1month or more. The clinical outcome were reviewed, retrospectively. RESULTS: The patients' chief complain was sudden visual loss (14 eyes, 70.0%) and at initial visit, eyes with OAH had mean visual acuity more than or equal 0.5 in 55.0%. The most common ocular sign is the retinal hemorrhage and choroidal infarction and the most associated systemic disease in these patients is the hypertension in 63.2%. Normal patency or mild changes of the internal carotid artery was seen in 75.0% on the side of OAH. CONCLUSIONS: Ophthalmic artery hypoperfusion has a comparatively good visual prognosis. However, the ophthalmologist's diagnosis may be crucial to the health of these patients, because OAH includes ocular ischemic syndrome that may be the presenting sign of serious cerebrovascular and ischemic heart disease.

A Case of Primary Endometrioid Adenocarcinoma of the Vagina / 대한산부인과학회지

Primary cancer of the vagina is very rare, accounting for 1-2% of gynecologic malignancies. Vaginal cancers are composed of primary and metastatic one. Of them, metastatic cancers constitute the majority of vaginal cancers, as 80-90%. Differentiating as type of cancer cell, the squamous cell carcinoma is the most common, as 80-90%, but, the adenocarcinoma is rare, as 9% of primary vaginal cancer. Same as other disease, if there is a symptom, the 5 year-survival rate of the vaginal cancer is 37%, but, if not in early stage, that becomes higher, as 61%. So, the early diagnosis and treatment are very important for patients' prognosis. A woman who had underwent both ovarian cystectomy due to both ovarian endometriomas 2 years ago visit us complaining of vaginal spotting, mild lower abdominal discomfort and pelvic pain for 2 months. She underwent operation at the impression of primary vaginal cancer and was irradiated. We report a case of primary endometrioid adenocarcinoma of the vagina with review of literatures.

Analysis of Family Practice Academic Dissertations

BACKGROUND: Family practice academic dissertations are the product of family practice research in the school of medicine. This paper was intended to evaluate the status of family practice academic dissertations, analyze the basic data and suggest directions for family practice research in the school of medicine. METHODS: The total number of masters' and doctoral dissertations from 1992 to February, 2005 was 124. of those, 120 were collected. They were analyzed in terms of research area, subjects, collected data, methodology, and statistical methods. RESULTS: In terms of research area, health promotion/ disease prevention was the most common (42.5%). For study subjects, out-patients and in-hospital patients were the most prevalent (38.0%), followed by health promotion center visitors and community residents (28.7%). When it came to research methodology, analytic study was the most common by a wide margin (70.8%). Among analytic studies, cross-sectional studies were the most frequent, followed by case-control studies and cohort studies. The most commonly-used data were medical records and questionnaires. CONCLUSION: Many advances have been made in research methodology and academic dissertation numbers since 1992. Many research topics, however, were not relevant to primary care. Much research was done in general hospital instead of primary-care facilities. These results must improve in the future.

Difficult Problems for Family Physicians in Clinical Practice

BACKGROUND: Real performance in practice is one of the criteria by which residency training program can be evaluated. We surveyed the difficult problems in which family physicians underwent in their practices after a university hospital training program to evaluate our family physician training program. METHODS: The study subjects were all physicians who fulfilled our family physician residency training program in a university hospital from February 1993 to February 1999. Data on facing difficult problems were collected via questionnaire which was distributed in advance and answered by practicing physicians. The study period was the first week of each month from March 1999 to December 1999. RESULTS: The participating physicians were 13 among 20. Total collected cases were 179. The reasons why family physicians faced difficulty in their practices were persistent symptoms of patients, lack of knowledge, lack of skills and facilities, vague symptoms, multiple symptoms of patients, low compliance, negative feelings, and patients' economic problems. Common difficult problems were abdominal pain (15), low back pain (14), cough (14), arthralgia and myalgia (12), skin rash (11), dyspnea (8), multiple somatic complaints (8), otitis media (7), nasal stuffiness (6), and dizziness (6) among 179 cases. Rare diseases comprised 22.2% of difficult problems. CONCLUSION: The problems of difficulty that family physicians faced in their practices were persistent symptoms of chronic diseases despite active treatment, lack of knowledge and skills in differential diagnosis of acute illness, and rare diseases in the communities.

The Quality Evaluation of Information of Websites on Colorectal Cancer Using the DISCERN Instrument

PURPOSE: Many patients rely on the Internet for medical information. In Korea, there are many websites providing medical information, but the quality of these websites relating to colorectal cancer remains to be clarified. This study was performed to evaluate the quality of websites providing information on colorectal cancer. METHODS: Firstly, sites were identified using four major domestic search engines and were classified according to the administrator. Then, two surgical oncologists used the 'DISCERN' instrument to assess 12 sites (including 2 foreign sites) for the reliability and the quality of the information on treatment choice. RESULTS: Total 297 sites were identified using the search term 'colorectal cancer'. Excluding dead links or duplicated sites, 148 sites were identified. When the sites had been classified according to the administrator of the websites, 115 (77.7%) were identified as local clinic or hospital sites, 8 (5.4%) as medical school sites, 7 (4.7%) as institute or public health sites, 11 (7.4%) as commercial sites, and 7 (4.7%) as private sites. The results of the evaluations by the two examiners showed moderate inter-examiner reliability (K=0.41). The evaluations of the domestic sites by using DISCERN showed serious or important shortcomings in the quality of information on treatment choices and in reliability. Among these domestic websites, the quality of information provided at private or local hospital sites was poorer than that provided at institute or public health sites. CONCLUSIONS: About 80% of the websites providing medical information on colorectal cancer were identified as private or local hospital sites. Evaluations of the information provided at domestic sites showed serious or important shortcomings.

Suitability Assessment of Patients' Education Materials Made by Korean Academy of Family Medicine

BACKGROUND: We assessed the suitability of patients' education materials made by KAFM (Korean Academy of Family Medicine) to suggest guidelines for making more efficient education materials. METHODS: The Korean version of SAM (Suitability Assessment of Materials) was used to evaluate patients' education materials of KAFM. The Korean version was modified within the centext of Korean language and culture by 3 family medicine specialists. We evaluated all materials which had been made up to October, 2003. Each item of evaluation criteria was assessed and agreed by 3 family medicine specialists. RESULTS: The total number of evaluated materials as 51. The average SAM score was 40.2% and its range was 22~78%. The materials on 'Early detection and self examination of breast cancer', 'Back muscle exercise for back pain patients', and 'Treatment and management of hypertension' received high scores. The materials on 'TIA', 'Alcohol and liver', and 'Children's constipation' received low scores. Two materials (3.9%) were judged excellent, 18 (35.3%) adequate, and 31 (60.8%) not adequate. The criteria for each item such as learning aids via road signs, layout factors, and typography received high scores. The criteria for each item such as summary or review included, 'context is given first', 'cover graphic shows purpose', relevance of illustrations, and 'caption used for graphics' received low scores. CONCLUSION: The items such as 'learning aids via road signs', 'layout factors', and 'typography' received high scores in the evaluation of patients' education materials by SAM criteria. There were also weak points noted about unclear purpose, less description about behavior change, irrelevance of illustrations, and lack of learning stimulation and motivation.

Smoking Types and Smoking Cessation Rate

BACKGROUND: Many factors are related to smoking cessation. Smoking types may play an important role. Our study is to find out whether smoking types are truly related to smoking cessation rate and smoking cessation trial rate. METHODS: We evaluated via questionnaire 433 male workers at a company who visited health promotion center at a university hospital. 'Why test' was used to analyze smoking types. RESULTS: Out of 433 workers, we excluded 89 workers who had never smoked before, and 29 workers who answered incompletely to the questionnaire. Among 315 workers evaluated, stimulation type was 43 cases, handling type 10 cases, pleasure/relaxation type 26 cases, crutch/tension type 114 cases, craving/addiction type 45 cases, and habit type 6 cases. Smoking cessation success rates were 15.7%, 25.0%, 30.0%, 13.3%, 23.5% and 0.0%, respectively, for each type among smoking cessation trial group. Smoking cessation success rate was 65.6% in a group who did not belong to any specific type. CONCLUSION: ISmoking cessation rates were higher in handling type, pleasure/relaxation types and craving/ addiction type among 6 smoking types. People who did not belong to any specific type showed the highest smoking cessation rate.

Asymptomatic Duodenal Ulcer Patient with Candidiasis due to Medical Treatment

Candida was found in the oral cavity, jejunum, and ileum of the healthy population. In case of alimentary tract, the factors of favorable to candida colonization include old age, malnutrition, diabetes, burns, trauma, surgical operations, parenteral nutrition, intravascular or bladder catheterization, H2-blocker therapy, steroid therapy, immunosuppresive treatment and the use of wide spectrum antibiotics: however, gastrointestinal candida colonization is rarely found in the healthy adult. No case of duodenal ulcer with candidiasis has been reported in healthy people. Recently we experienced a case of asymptomatic duodenal ulcer with candidiasis in a healthy male, who had taken H2-blocker and proton pump inhibitor for 3 months after primary closure of duodenal ulcer perforation. Therefore we report this case with review of several literatures.

Aspirin Reduces Acute Lung Injury in Rats Subjected to Severe Hemorrhage / 결핵

BACKGROUND: Hemorrhagic shock and trauma are two of the most common causes of acute lung injury. The activation of cyclooxygenase is one of the important causes of acute lung injury. This study investigated the effect of aspirin, a well-known cyclooxygenase inhibitor, on severe hemorrhage-induced acute lung injury in rats. METHODS: The hemorrhagic shock was induced by withdrawing blood; 20ml/kg of B.W., through the femoral artery in 5 min. The mean arterial pressure was recorded through the femoral artery on a polygraph. RESULTS: In the present investigation, the lung tissue myeloperoxidase activity, protein contents and leukocyte counts, in bronchoalveolar lavage fluid, increased significantly 2 and 24 h after the hemorrhage induction. Although the decreased mean arterial pressure spontaneously recovered, acute lung injury occurred after severe hemorrhage. These changes were effectively prevented by a single intravenous injection of aspirin (10 mg/kg of B.W.) 30 min before the hemorrhage. CONCLUSION: These results suggest that severe hemorrhage-induced acute lung injury is mediated, in part, by the activation of cyclooxygenase. Furthermore, pretreatment of aspirin in acute lung injury-prone patients, or prophylactic treatment of aspirin to the patients with precipitating conditions, could be helpful in the prevention of acute lung injury.

Impact of Personal Computer Use on Musculoskeletal Symptoms in Middle and High School Students

BACKGROUND: There are few studies on the musculoskeletal syndromes from PC use in teenagers. This study investigates the prevalence of musculoskeletal symptoms and its risk factors in school age teenagers who spend time using personal computer with the purpose of preventing such condition. METHODS: The field study was conducted from January to March 2001 at seven PC Bangs in Kimchun. Three hundred twelve teenagers participated in the study. A questionnaire survey was done on how many hours of computer use in a day, their posture, and degree and site of musculoskeletal pain. A physician examined the pressure point around the neck and shoulder and measured the angle of neck, height of the elbow, inner angle of the elbow, angle of the wrist, the distance between the eyes and the monitor while using the computer. RESULTS: The average duration of computer use was 48.1 21.8 months. The average time spent on computer per day was 4.9 1.9 hours. The prevalence of myofascial pain syndrome (MPS) was 36.5% at the neck and shoulder. There was a statistically significant relationship between school grade and the prevalence of MPS at the neck and shoulder (P<0.05). Odds ratio of MPS between middle and high school students was 1.67 at the neck and shoulder (95% C.I: 1.02~2.74). The posture of computer use were not related to the musculoskeletal symptoms. However, there was a significant positive relationship between the average height of elbow and the prevalence of MPS at the neck and shoulder (P<0.05). CONCLUSIONS: We found that posture of computer use and average time spent on computer was related to MPS, assuming that MPS could be increased by those factors. In order to prevent teenagers from MPS resulting from prolonged use of computer, it is essential to fit the desk and chair to their body configuration and instruct them to keep proper posture for computer use.

Stress-related Physical Symptoms and Stress Managements among the Acarins

BACKGROUND: A worshipper lives a well-regulated life with rigid discipline. This study aims at measuring the stress level of the acarins (preliminary monks) using BEPSI-K (Brief Encounter Psychosocial Instrument-Korea) and finding out their stress management. METHODS: One hundred forty six male acarins and 111 female acarins who participated in an educational program at a local temple in Sep. 2001 are included in this survey. Using BEPSI-K, we asked them how they use their spare time, their stress management and physical symptoms. SPSS ver. 10.1, one-way ANOVA and independent t-test were used for statistical process. RESULTS: Average BEPSI-K score was high among the age group of 15-19 by age (P<0.05). In academic career, the lower the average BEPSI-K score, the higher in education (P<0.01). In physical symptoms, the average score of headache (P<0.05), epigastric soreness (P<0.05), fatigue (P<0.01), GI problem (P<0.01) were significantly high. Prayer, Zen meditation, bowing, sutras study, and sound a wooden gong were counted as the stress management, which were not significant. CONCLUSION: The stress level of the acarins was lower than normal population. The physical symptoms from stress were significant. Zen meditation and prayer were similar to meditation as the stress management. Further study for releasing stress is needed.

The level of child-caretakers' knowledge about weaning food

BACKGROUND: It is an important task to give adequate nutritions to infants and to wean properly for rapid growth during infancy. Adequate behavior requires precise knowledge. This study was conducted to assess the level of child-caretakers' knowledge about weaning food which is essential to infants' healthy growth. METHODS: From April to June, 1997, we acquired 156 child-caretakers who visited a family medicine clinic in Kyungju and a pediatric clinic in Taegu(from 2months old to 6 years old) medical care. They were asked respond to the pre-made questionnaire. The data were coded and analyzed using Excel and SPSS/PC(version 7.0). Student's t-test was used to test the score difference between two groups by general characteristics. RESULTS: The proportion of correct answers to the question concerning the definition of weaning, was 66.7% ; on proper feeding method when infants do not accept weaning food. 18.5% ; on startion time of weaning food, 64.1% ; on the interval to add new ingredient, 23.1% ; on the sequence of feeding weaning food compared to milk or breast milk. 56.4% ; on How to prepare commercial weaning food, 54.5% ; and to the question in the completing time of weaning food, the proportion of correct answers was 19.2%. The main information sources on weaning food were books and magazines related to child care and rearing(50.6%). The total average score was 4.6/1.0. CONCLUSION: There are many child-caretakers who misunderstand the knowledge of weaning food. Therefore, primary care physician plays an important role in the education of child-caretakers on weaning food.