Molecular and serological surveillance of equine piroplasmosis in the Republic of Korea between 2016 and 2017

Equine piroplasmosis (EP) is caused by Babesia caballi and Theileria equi infection. We investigated antigen and antibody of EP in horses in the Republic of Korea during 2016-2017. Antigen and antibody of T. equi was detected 0.06% (1/1,650). Phylogenetic analysis of 18S rRNA revealed that the T. equi was highly homologous with the strains from China, Mongolia, and Spain. Two Theileria spp. were also detected and highly homologous with T. buffeli, T. luwehshuni, and T. orientalis.

Molecular and serological surveillance of equine piroplasmosis in the Republic of Korea between 2016 and 2017

Equine piroplasmosis (EP) is caused by Babesia caballi and Theileria equi infection. We investigated antigen and antibody of EP in horses in the Republic of Korea during 2016-2017. Antigen and antibody of T. equi was detected 0.06% (1/1,650). Phylogenetic analysis of 18S rRNA revealed that the T. equi was highly homologous with the strains from China, Mongolia, and Spain. Two Theileria spp. were also detected and highly homologous with T. buffeli, T. luwehshuni, and T. orientalis.

Seroprevalence and B1 gene Phylogeny of Toxoplasma gondii of Dogs and Cats in Republic of Korea

The outbreak of human toxoplasmosis can be attributed to ingestion of food contaminated with Toxoplasma gondii. Toxoplasmosis recently increased in domestic and stray dogs and cats. It prompted studies on the zoonotic infectious diseases transmitted via these animals. Sero- and antigen prevalences of T. gondii in dogs and cats were surveyed using ELISA and PCR, and B1 gene phylogeny was analyzed in this study. Toxoplasmosis antibodies were measured on sera of 403 stray cats, 947 stray dogs, 909 domestic cats, and 2,412 domestic dogs collected at nationwide regions, Korea from 2017 to 2019. In addition, whole blood, feces, and tissue samples were also collected from stray cats (1,392), stray dogs (686), domestic cats (3,040), and domestic dogs (1,974), and T. gondii-specific B1 gene PCR was performed. Antibody prevalence of stray cats, stray dogs, domestic cats, and domestic dogs were 14.1%, 5.6%, 2.3%, and 0.04%, respectively. Antigen prevalence of these animals was 0.5%, 0.2%, 0.1%, and 0.4%, respectively. Stray cats revealed the highest infection rate of toxoplasmosis, followed by stray dogs, domestic cats, and domestic dogs. B1 gene positives were 5 of stray cats, and identified to high/moderate pathogenic Type I/III group. These findings enforce that preventive hygienic measure should be strengthened at One Health level in dogs and cats, domestic and stray, to minimize human toxoplasmosis infections.

Ectopic migration of Dirofilaria immitis in a Eurasian otter (Lutra lutra) in Korea

An 8-year-old female Eurasian otter (Lutra lutra) reared in a wetland center, died 2 h after sudden onset of astasia and dyspnea despite medical treatment. Gross examination of internal organs revealed 10 adult filarioid nematodes in the right ventricle of the heart and three between the left and right cerebral hemispheres. All nematodes were identified as Dirofilaria immitis by direct microscopy and polymerase chain reaction assay. Histopathological observation revealed multifocal hemorrhage in the cerebral subarachnoid space and focal necrosis with hemorrhagein the cerebellar parenchyma. Although rare, veterinarians should consider cerebral dirofilariasis as a differential diagnosis in unexplained neurological cases.

Ectopic migration of Dirofilaria immitis in a Eurasian otter (Lutra lutra) in Korea / 대한수의학회지

An 8-year-old female Eurasian otter (Lutra lutra) reared in a wetland center, died 2 h after sudden onset of astasia and dyspnea despite medical treatment. Gross examination of internal organs revealed 10 adult filarioid nematodes in the right ventricle of the heart and three between the left and right cerebral hemispheres. All nematodes were identified as Dirofilaria immitis by direct microscopy and polymerase chain reaction assay. Histopathological observation revealed multifocal hemorrhage in the cerebral subarachnoid space and focal necrosis with hemorrhagein the cerebellar parenchyma. Although rare, veterinarians should consider cerebral dirofilariasis as a differential diagnosis in unexplained neurological cases.

Species Diversity and Seasonal Distribution of Culicoides spp. (Diptera: Ceratopogonidae) in Jeju-do, Republic of Korea

Biting midges belonging to the genus Culicoides (Diptera: Ceratopogonidae) were collected by Mosquito Magnet(R) and black light traps at 5 sites on Jeju-do, Republic of Korea (Korea), from May-November 2013 to determine species diversity and seasonal distribution. A total of 4,267 specimens were collected, of which 99.9% were female. The most common species was Culicoides tainanus (91.8%), followed by C. lungchiensis (7.2%) and C. punctatus (0.6%), while the remaining 4 species accounted for <0.5% of all Culicoides spp. that were collected. High numbers of C. tainanus were collected in May, followed by decreasing numbers through August, and then increasing numbers through November when surveillance was terminated. Peak numbers of C. lungchiensis were collected during September, with low numbers collected from May-August and October-November. The presence of C. lungchiensis in Korea was confirmed by morphological and molecular analyses.

Detection and Identification of the Spotted Fever Group Rickettsial Agents from Haemaphysalis Ticks in Jeju Island, Korea

This study investigated the presence of nucleic acids of various Rickettsial agents in ticks collected in Jeju Island, Korea from June 2007 to August 2008, through the nested polymerase chain reaction (PCR) and sequencing analysis of partial citrate synthase (gltA), Rickettsial outer membrane protein B (ompB), and 17-kDa genes. Examination of the 1,584 ticks showed that the subspecies distribution of Haemaphysalis longicornis was 99.81% (n=1,581) and H. flava was 0.19% (n=3). A total 224 out of 250 pools from one to 15 ticks were found to be positive in ompB-PCR assay (minimal infection rate 141 ticks/1,000 tested). From the positive samples, 26 were analyzed by gltA- and 17-kDa-PCR assays. The nucleotide sequences of the ompB- and gltA-PCR products showed a high degree of similarity with those of the Rickettsia japonica (98.7~99.2% and 98.7~99.3%, n=25) and R. monacensis (99% and 99.7%, n=1). However, analysis of the nucleotide sequences of the 17-kDa-PCR amplicons showed that the sequences of the 25 PCR amplicons were more close to R. marmionii (99.4~100%) than R. japonica (98.6~99.1%). These findings suggest that various rickettsial diseases could be transmitted via the bite of tick vectors in Jeju Island, Korea.

Thyroid Dysfunction in Premature Infants

PURPOSE: Severe neonatal hypothyroxinemia is associated with leukomalacia, intraventicular hemorrhage and long-term neurodevelopmental disability. We designed this study to evaluate the incidence of thyroid dysfunctions and the effects of low T4 level on neonatal morbidity to establish the basis for the thyroid hormone supplementation. METHODS: Thyroid function tests, measured by radioimmunoassay and filter paper screening, were obtained from the preterm infants with birth weights less than 2000 g. The first measurement was done during 2nd week of life followed by the measurement at 2 weeks later and repeated until normalized. RESULTS: 17/32 (53.1%) infants had thyroid dysfunction: Four infants had hypothyroidism, twelve infants had hypothyroxinemia and one infant had hyperthyrotropinemia. The frequency of thyroid dysfunction showed inverse relationship to the birth weight. All infants with birth weights less than 1, 000 g, 11 infants (70.6%) with birth weights between 1, 000 and 1, 499 g and two infants (18.2%) with birth weights more than 1500 g had thyroid dysfunction. Nine infants with thyroid dysfunction were not detected by filter paper screening test. Infants with hypothyroxinemia had more RDS, longer mechanical ventilation days and hospital stay compared to the infants with normal T4 level. CONCLUSION: Thyroid dysfunction is frequently observed in premature infants and it can be associated with increased neonatal morbidity. Serial follow up of thyroid function test is recommened among premature infants.

Significance of Aseptic Room Reverse Isolation in Febrile Neutropenic Cancer Patients / 대한소아혈액종양학회지

PURPOSE: The aim of this study is to find out the role of HEPA filter equipped lamina air flow room reverse isolation for the treatment of anticancer drug induced febrile neutropenic patients. METHODS: Antibiotics and antifungal agents were promptly administered to twenty six patients with febrile neutropenic following chemotherapy from January 2003 to July 2005 at the Department of Pediatrics, Kyungpook National University Hospital, Daegu, Korea. And if possible, they were treated in the aseptic room. RESULTS: Nineteen patients recovered and seven patients died of infectious causes among twenty six patients. Fourteen patients had microbiologically defined infection, seven patients had clinically defined infection, and five patients had unexplained fever. The causes of infection were sepsis, pneumonia and urinary tract infection. The etiologic pathogens were Gram negative bacilli, 6 (42.9%) ; Gram positive cocci, 3 (21.4%) ; and fungus, 5 (35.7%). The dead group showed lower leukocyte count and higher CRP than the survived group. All dead patients showed disseminated intravascular coagulation syndrome (DIC). Nine of the ten patients (90%) who were treated in the aseptic room survived and ten of the sixteen patients (62.5%) in the general ward survived. CONCLUSION: The infection-related mortality of febrile neutropenic patients following chemotherapy is influenced by the early and adequate use of antimicrobial agents, DIC, neutrophil count and CRP. The isolation in the aseptic room increased the survival rate, but it was not statistically significant.

Two Cases of Pleuropulmonary Blastomas in Children / 대한소아혈액종양학회지

Pleuropulmonary blastoma (PPB) is a rare primary malignant neoplasm with poor prognosis in children. PPB originates from the lung, the pleura, or the mediastinum. Histologically, it is characterized by a primitive, mixed blastematous, sarcomatous appearance and the absence of epithelial cell. Initial presenting symptoms are cough, fever and dyspnea. We experienced two cases of PPB (type I and type II). Complete surgical removal is always required for the treatment and chemotherapy and radiotherapy is needed as adjuvant therapy. We report two cases of pleuropulmonary blastoma treated with surgical removal, chemotherapy (vincristine, actinomycin D, cyclophosphamide) and radiotherapy.

A Cytogenetic Study in Patients with Sex Chromosome Abnormalities / 소아과

PURPOSE: This study was performed to evaluate the recent frequency of karyotypes in different sex chromosome abnormalities and to evaluate the age and clinical manifestations at diagnosis. METHODS: Peripheral blood leukocytes were obtained from subjects who were clinically suspected to have sex chromosome abnormalities and referred to the cytogenetic laboratory in the Department of Pediatrics, Kyungpook National University Hospital from February 1981 to August 2001. RESULTS: The relative frequencies of different sex chromosome abnormalities were Klinefelter (52 percent), Turner (42 percent), XXX syndrome (3 percent) and mixed gonadal dysgenesis (3 percent). The populations of different karyotypes in Klinefelter syndrome were 47, XXY (97 percent) and 46, XY/ 47, XYY (3 percent). The populations of different karyotypes in Turner syndrome were 45, X (67 percent, ), mosaicism (23 percent), and structural aberrations (10 percent). The populations of different karyotypes in XXX syndrome were 47, XXX (67 percent, ) and 46, XX/47, XXX (33 percent). All mixed gonadal dysgenesis were 45, X/46, XY. Eighty one percent of sex chromosome abnormalities was diagnosed after puberty. Patients diagnosed with Klinefelter and Turner syndrome in infancy showed nearly normal phenotypes or had minor congenital malformations. CONCLUSION: Early diagnoses of sex chromosome abnormalities is required to prevent associated morbidities and to maximize growth and development. We have to pay careful attention in diagnoses of Turner syndrome because of the high proportion of mosaicism and structural aberrations.

Late Endocrine Complications in Childhood Cancer Survivors / 대한소아혈액종양학회지

PURPOSE: This study is aimed to find out the incidence of late endocrine complications in children who were treated for childhood cancer. METHODS: We reviewed the medical records of 60 patients who was treated for childhood cancer and evaluated various pituitary hormonal functions after completion of treatment from July 1985 to September 2004 at Kyungpook National University Hospital. RESULTS: Forty-four boys (73.3%) and sixteen girls (26.7%) were involved in the study and their ages ranged from 2 months to 14 years. Twenty-four patients were treated with chemotherapy with cranial irradiation and thirty-six were treated with chemotherapy only. The diagnoses included ALL (n=27, 45.0%), AML (n=2, 3.3%), malignant lymphoma (n=13, 21.7%), brain tumor (n=5, 8.3%), MDS (n=1, 1.7%), and other solid tumor (n=12, 20.2%). Forty-four (73.3%) out of the 60 patients had an additional endocrine abnormality. Growth hormone deficiency (GHD) was identified in 44 children (73.3%). Incidence of GHD was significantly higher among those who had received cranial irradiation (91.6% vs. 61.1%) (P=0.009) but this kind of difference was not found in ALL 27 patients (93.7% vs. 72.7%) (P=0.131). Only one patient was diagnosed as primary hypothyroidism, two patients were diagnosed as primary hypogonadism, and these three patients showed growth hormone deficiency. No patient had abnormalities of ACTH and cortisol. CONCLUSION: We thought that late endocrine complications were very common in childhood cancer survivors. Accordingly, we recommended that we should focus on endocrine abnormalities while treating and following up the patients.

A Comparison of Rectal, Axillary, and Skin-to-Mattress Temperatures in Neonates

PURPOSE: This study was conducted to evaluate the comparability and accuracy of body temperatures measured at three different sites: rectum, axilla and between skin and mattress in the newborn infants. METHODS: 168 term and preterm infants admitted to NICU at Kyungpook University Hospital were enrolled in the study. Glass and digital thermometers were used for the simultaneous measurement of rectal, axilla and skin-to-mattress temperatures. RESULTS: Among three different body temperatures measured by glass thermometer, the rectal temperatures recorded the highest in the bassinet, while no differences were found in the incubator. Rectal temperature by glass thermometer agreed most closely with axillary temperature by digital thermometer. The digital thermometers took significantly less time to measure temperatures from rectum and axilla than glass thermometer. Phototherapy did not influence body temperature measured in the incubator. CONCLUSION: In the bassinet, axilla temperature measured by a digital thermometer was as reliable as rectal temperature measured by a glass thermometer. Skin-to-mattress temperature provides an accurate, safe and easily accessible alternative site while infants are in the incubator.