Air and Environmental Contamination Caused by COVID-19 Patients: a MultiCenter Study

Background@#The purpose of this study was to determine the extent of air and surface contamination of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in four health care facilities with hospitalized coronavirus disease 2019 (COVID-19) patients. @*Methods@#We investigated air and environmental contamination in the rooms of eight COVID-19 patients in four hospitals. Some patients were in negative-pressure rooms, and others were not. None had undergone aerosol-generating procedures. On days 0, 3, 5, and 7 of hospitalization, the surfaces in the rooms and anterooms were swabbed, and air samples were collected 2 m from the patient and from the anterooms. @*Results@#All 52 air samples were negative for SARS-CoV-2 RNA. Widespread surface contamination of SARS-CoV-2 RNA was observed. In total, 89 of 320 (27%) environmental surface samples were positive for SARS-CoV-2 RNA. Surface contamination of SARSCoV-2 RNA was common in rooms without surface disinfection and in rooms sprayed with disinfectant twice a day. However, SARS-CoV-2 RNA was not detected in a room cleaned with disinfectant wipes on a regular basis. @*Conclusion@#Our data suggest that remote (> 2 m) airborne transmission of SARS-CoV-2 from hospitalized COVID-19 patients is uncommon when aerosol-generating procedures have not been performed. Surface contamination was widespread, except in a room routinely cleaned with disinfectant wipes.

Repeated Glucose Deprivation/Reperfusion Induced PC-12 Cell Death through the Involvement of FOXO Transcription Factor

BACKGROUND: Cognitive impairment and brain damage in diabetes is suggested to be associated with hypoglycemia. The mechanisms of hypoglycemia-induced neural death and apoptosis are not clear and reperfusion injury may be involved. Recent studies show that glucose deprivation/reperfusion induced more neuronal cell death than glucose deprivation itself. The forkhead box O (FOXO) transcription factors are implicated in the regulation of cell apoptosis and survival, but their role in neuronal cells remains unclear. We examined the role of FOXO transcription factors and the involvement of the phosphatidylinositol 3-kinase (PI3K)/Akt and apoptosis-related signaling pathways in PC-12 cells exposed to repeated glucose deprivation/reperfusion. METHODS: PC-12 cells were exposed to control (Dulbecco's Modified Eagle Medium [DMEM] containing 25 mM glucose) or glucose deprivation/reperfusion (DMEM with 0 mM glucose for 6 hours and then DMEM with 25 mM glucose for 18 hours) for 5 days. MTT assay and Western blot analysis were performed for cell viability, apoptosis, and the expression of survival signaling pathways. FOXO3/4',6-diamidino-2-phenylindole staining was done to ascertain the involvement of FOXO transcription factors in glucose deprivation/reperfusion conditions. RESULTS: Compared to PC-12 cells not exposed to hypoglycemia, cells exposed to glucose deprivation/reperfusion showed a reduction of cell viability, decreased expression of phosphorylated Akt and Bcl-2, and an increase of cleaved caspase-3 expression. Of note, FOXO3 protein was localized in the nuclei of glucose deprivation/reperfusion cells but not in the control cells. CONCLUSION: Repeated glucose deprivation/reperfusion caused the neuronal cell death. Activated FOXO3 via the PI3K/Akt pathway in repeated glucose deprivation/reperfusion was involved in genes related to apoptosis.

A Gigantic Gastric Mucosal Rupture When Performing Endoscopy under Conscious Sedation in a Patient with Hiatal Hernia / 대한소화기내시경학회지

Mallory-Weiss syndrome is a tear in the gastro-esophageal junction or its adjacent mucosa, and this occurs due to nausea or vomiting that is caused by various etiologic factors. It may occur in patients with excessive retching and struggling when undergoing upper gastrointestinal endoscopy, and its underlying factors are esophageal hiatal hernia, atrophic gastritis and old age. There are currently only rare reports about gigantic gastric mucosal rupture during performance of upper gastrointestinal endoscopy in patients with esophageal hiatal hernia. We recently experienced a 76-year-old woman who developed a gigantic gastric mucosal rupture that ranged from the gastro-esophageal junction to the gastric angle. This occurred during performance of standard upper gastrointestinal endoscopy with the patient under sedation and the patient had a concurrent esophageal hiatal hernia. The patient was treated conservatively for the rupture. Herein we report on our case along with a review of the relevant literature.

Clinical Manifestation and Therapeutic Effect of Azathioprine in Lupus Nephritis of Children / 대한신장학회잡지

PURPOSE: The incidence of clinical nephritis is much higher especially in younger ages and in about one half of the cases, it also shows nephrotic syndrome. Thus, we examine the clinical and pathologic consideration of children with lupus nephritis and their treatment modality to improve the prognosis. MATERIAL AND METHOD: Among 67 cases of children under eighteen who were diagnosed SLE, 50 patients with hematuria and proteinuria from Jan. 1980 to Dec. 1996 were selected for the review. RESULTS: The ratio of the male to female patient was 1:3.5 and the average age at the diagnosis was 11.85+/-3.2 years old. Most common clinical manifestations at the time of the diagnosis were fever and skin rashes and the common laboratory results were proteinuria, hematuria, Out of 50 cases, 33 cases had renal biopsy. The results were 17 cases of Class IV, 7 cases of Class lll, 5 cases of Class lll, 3 cases of Class V and 1 case of Class l. Different treatment modalities were carried out; Corticosteroid only 21 cases, Corticosteroid+Azathioprine 25 cases, Corticosteroid+Cyclophosphamide 3 cases, and Corticosteroid+Cyclosporine A 1 case. However, there were no significant difference in the recurrence and complete remission rate of lupus nephritis in between each treatment groups. Average follow-up period was 37+/-23 months. Of all the follow-ups, 7 patients were dead. CONCLUSION: Early diagnosis should be carried out with renal biopsy, and should be considered for vigorous therapy, which currently includes high doses of corticosteroids and immunosuppressive drugs. Among these immunosuppressive agents, azathioprine has a lower incidence of long-term complications and low costs might be recommended. In addition, regular check-up for anti-DNA antibody, serum complement concentration and appropriate moniroting and management for the adverse effects of the treatment should enable to reach the continuous remission.

Cystic Diseases of the Kidney in Chidren

A case of metastatic adenoid cystic carcinoma of the lung, originated from the trachea, was diagnosed by fine needle aspiration. Although the cytologic features of adenoid cystic carcinoma have been well described, it is easy to confuse adenoid cystic carcinoma with more common primary small cell neoplasms of the lung, i.e., small cell carcinoma, well differentiated adenocarcinoma, and carcinoid tumor of the lung. The features distinguishing adenoid cystic carcinoma from these neoplasms include 1) tight, globular, honeycomb pattern of cells, 2) acelluair basement membrane material in the lumen, and 3) cells lacking true nuclear molding and having bland chromatin pattern. The mcrphologic feature of metastatic adenoid cystic carcinoma in this case was so distinctive as to permit a definite diagnosis by aspiration cytology.