ABSTRACT
Trichoderma fungi have been intensively studied for mycoparasitism, and the latter is closely related to their cell-wall degrading enzymes including chitinase. Here, we studied marinederived Trichoderma spp., isolated from distinct sources and locations, for chitinolytic and antifungal activity. Based on morphological and phylogenetic analyses, two strains designated GJ-Sp1 and TOP-Co8 (isolated from a marine sponge and a marine alga, respectively) were identified as Trichoderma bissettii. This species has recently been identified as a closely related species to Trichoderma longibrachiatum. The extracellular crude enzymes of GJ-Sp1 and TOP-Co8 showed activities of chitobiosidase and β-N-acetylglucosaminidase (exochitinase) and chitotriosidase (endochitinase). The optimum chitinolytic activity of the crude enzymes was observed at 50°C, pH 5.0, 0–0.5% NaCl concentrations, and the activities were stable at temperatures ranging from 10 to 40 C for 2 h. Moreover, the crude enzymes showed inhibitory activity against hyphal growth of two filamentous fungi Aspergillus flavus and Aspergillus niger. To the best of our knowledge, this is the first report of the chitinolytic and antifungal activity of T. bissettii.
ABSTRACT
Background@#The purpose of this study is to describe the current status of the payment rate of the Korean Medical Association (KMA) membership fee and to suggest a way to overcome the decreased payment rate of membership fees by analyzing the causal factors of the decrease. @*Methods@#Quantitative analysis of the KMA membership data, qualitative research of in-depth interviews with 2 staff members of the regional subsidiaries, and literature research were conducted. @*Results@#From the results, 6 major factors for reducing the membership fee payment rate were derived, and plans to improve the payment rate of membership fees were suggested to improve the factors. First, the role of the KMA and the promotion of its members should be strengthened. Second, there should be a flexible adjustment of the membership fee. Third, there should be an enhancement of the transparency of budget execution and increased awareness through the promotion of the members. Fourth, differentiated incentives should be offered to the members who pay dues. Fifth, an improvement of a more efficient and easier payment method should be installed. Finally, legal enforcement measures to pay the membership fee should be considered. @*Conclusion@#In order to improve the payment rate of the KMA membership fee, the KMA should try to make the members understand the performance of the business affairs and health policies. Furthermore, incentives that members can feel should be given.
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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.
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Objective@#To evaluate the impact of surgical simulation training using a three-dimensional (3D)-printed model of tetralogy of Fallot (TOF) on surgical skill development. @*Materials and Methods@#A life-size congenital heart disease model was printed using a Stratasys Object500 Connex2 printer from preoperative electrocardiography-gated CT scans of a 6-month-old patient with TOF with complex pulmonary stenosis.Eleven cardiothoracic surgeons independently evaluated the suitability of four 3D-printed models using composite Tango 27, 40, 50, and 60 in terms of palpation, resistance, extensibility, gap, cut-through ability, and reusability of. Among these, Tango 27 was selected as the final model. Six attendees (two junior cardiothoracic surgery residents, two senior residents, and two clinical fellows) independently performed simulation surgeries three times each. Surgical proficiency was evaluated by an experienced cardiothoracic surgeon on a 1–10 scale for each of the 10 surgical procedures. The times required for each surgical procedure were also measured. @*Results@#In the simulation surgeries, six surgeons required a median of 34.4 (range 32.5–43.5) and 21.4 (17.9–192.7) minutes to apply the ventricular septal defect (VSD) and right ventricular outflow tract (RVOT) patches, respectively, on their first simulation surgery. These times had significantly reduced to 17.3 (16.2–29.5) and 13.6 (10.3–30.0) minutes, respectively, in the third simulation surgery (p = 0.03 and p = 0.01, respectively). The decreases in the median patch appliance time among the six surgeons were 16.2 (range 13.6–17.7) and 8.0 (1.8–170.3) minutes for the VSD and RVOT patches, respectively. Summing the scores for the 10 procedures showed that the attendees scored an average of 28.58 ± 7.89 points on the first simulation surgery and improved their average score to 67.33 ± 15.10 on the third simulation surgery (p = 0.008). @*Conclusion@#Inexperienced cardiothoracic surgeons improved their performance in terms of surgical proficiency and operation time during the experience of three simulation surgeries using a 3D-printed TOF model using Tango 27 composite.
ABSTRACT
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.
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Objective@#To evaluate the impact of surgical simulation training using a three-dimensional (3D)-printed model of tetralogy of Fallot (TOF) on surgical skill development. @*Materials and Methods@#A life-size congenital heart disease model was printed using a Stratasys Object500 Connex2 printer from preoperative electrocardiography-gated CT scans of a 6-month-old patient with TOF with complex pulmonary stenosis.Eleven cardiothoracic surgeons independently evaluated the suitability of four 3D-printed models using composite Tango 27, 40, 50, and 60 in terms of palpation, resistance, extensibility, gap, cut-through ability, and reusability of. Among these, Tango 27 was selected as the final model. Six attendees (two junior cardiothoracic surgery residents, two senior residents, and two clinical fellows) independently performed simulation surgeries three times each. Surgical proficiency was evaluated by an experienced cardiothoracic surgeon on a 1–10 scale for each of the 10 surgical procedures. The times required for each surgical procedure were also measured. @*Results@#In the simulation surgeries, six surgeons required a median of 34.4 (range 32.5–43.5) and 21.4 (17.9–192.7) minutes to apply the ventricular septal defect (VSD) and right ventricular outflow tract (RVOT) patches, respectively, on their first simulation surgery. These times had significantly reduced to 17.3 (16.2–29.5) and 13.6 (10.3–30.0) minutes, respectively, in the third simulation surgery (p = 0.03 and p = 0.01, respectively). The decreases in the median patch appliance time among the six surgeons were 16.2 (range 13.6–17.7) and 8.0 (1.8–170.3) minutes for the VSD and RVOT patches, respectively. Summing the scores for the 10 procedures showed that the attendees scored an average of 28.58 ± 7.89 points on the first simulation surgery and improved their average score to 67.33 ± 15.10 on the third simulation surgery (p = 0.008). @*Conclusion@#Inexperienced cardiothoracic surgeons improved their performance in terms of surgical proficiency and operation time during the experience of three simulation surgeries using a 3D-printed TOF model using Tango 27 composite.
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BACKGROUND: Suicide is a significant public health problem worldwide. Suicide rates among elderly persons (≥ 65 years of age) are three times higher than those of younger people in Korea. The emergency department is an important entry of drug-related suicide attempt patients. In this study, we compared the frequency of drug types by age subgroup. Furthermore, we provide suggestions for preventing suicide attempts in the elderly. METHODS: We investigated 433 patients who were admitted to the emergency department for drug-related suicide attempts between 1 May 2015 and 30 April 2017. RESULTS: The proportion of patients who overdosed on antidepressants was 32.5% in the non-elderly age group and 8.0% in the elderly group (≥ 65 years of age) (P < 0.001). Among the elderly, the most commonly ingested agent was hypnotics (59.1%) (P < 0.001). Compared with the non-elderly, the results showed that the elderly used fewer antidepressants (P < 0.001) and analgesics (P < 0.001). Meanwhile, the elderly used more hypnotics (P < 0.001). Over-the-counter drugs and other medications showed similar usage trends in both age groups (P = 0.664, P = 0.193). CONCLUSION: The categories of drugs ingested for suicide attempts vary widely between different age groups. Younger people used antidepressants more frequently in suicide attempts, while the elderly used hypnotics more frequently. And the elderly required longer hospital stays. Suicide ideation and depressive mood in older patients who are prescribed hypnotics for various reasons should not be neglected. Further prevention efforts are needed to prevent suicide among the elderly.
Subject(s)
Aged , Humans , Analgesics , Antidepressive Agents , Emergency Service, Hospital , Hypnotics and Sedatives , Korea , Length of Stay , Nonprescription Drugs , Public Health , SuicideABSTRACT
Epigastric pain is a common symptom in the emergency department. Most epigastric pain is not fatal, except in acute myocardial infarction, aortic dissection, and abdominal aneurysm rupture. Epigastric pain can also be the only symptom of isolated spontaneous gastric artery dissection. We report the case of a 51-year-old woman diagnosed with neurofibromatosis who initially presented with only epigastric pain. She was initially misdiagnosed with gastritis, treated conservatively, and discharged. Two hours later, she returned to the emergency department with persistent epigastric pain and rebound tenderness in the epigastric area. Angiography revealed a left hepatic arterial aneurysm and right gastric artery dissection, which were subsequently embolized. Although extremely rare, patients presenting with epigastric pain at risk of vasculopathies should be considered for isolated spontaneous gastric artery dissection. Early recognition and definitive therapy lead to a favorable outcome.
Subject(s)
Female , Humans , Middle Aged , Aneurysm , Angiography , Arteries , Emergency Service, Hospital , Gastritis , Hepatic Artery , Myocardial Infarction , Neurofibromatoses , RuptureABSTRACT
Eccrine angiomatous hamartomas are benign vascular and eccrine malformations often accompanied by hyperhidrosis or pain, increased eccrine glands, and aggregates of vessels. Verrucous hemangiomas are congenital vascular malformations presenting as unilateral grouped papules. Histologically, they show verrucous epidermal change and proliferation of capillaries in the dermis. We report a case of a 47-year-old woman with a red keratotic patch overlying a bluish plaque on the right sole, which had been present since birth. It was accompanied by pain and hyperhidrosis. Histologically, there were verrucous changes in the epidermis, numerous dilated capillaries in the papillary dermis, and increased eccrine glands with angiomatous foci in the deep dermis. The epithelial cells of the eccrine glands were positive for CEA, and the endothelial cells were positive for CD31 and GLUT-1. Eccrine angiomatous hamartomas have been reported in conjunction with other vascular tumors in only a few instances. We report an interesting case of an eccrine angiomatous hamartoma associated with a verrucous hemangioma.
Subject(s)
Female , Humans , Middle Aged , Capillaries , Dermis , Eccrine Glands , Endothelial Cells , Epidermis , Epithelial Cells , Hamartoma , Hemangioma , Hyperhidrosis , Parturition , Vascular MalformationsABSTRACT
Superficial epithelioma with sebaceous differentiation (SESD) is a rare benign neoplasm that shows unique histologic features despite of the non-specific clinical findings. It is histopathologically characterized by a superficial multilobular plate-like proliferation of basaloid cells with clusters of sebocytes, and the plate-like proliferation has numerous broad attachments to the overlying epidermis. We report here on a case of multiple SESDs that presented on the trunk and extremities of 59-year-old woman.
Subject(s)
Female , Humans , Middle Aged , Carcinoma , Epidermis , ExtremitiesABSTRACT
BACKGROUND: There are various treatment options for congenital melanocytic nevus (CMN), including surgical excision, dermabrasions, curettage, laser treatment, chemical peels and cryosurgery. The proper choice of treatment depends on the size, location, thickness and clinical appearance of the nevi, the risk for developing melanoma, the psychological effect and the cosmetic component. OBJECTIVE: The purpose of this study is to evaluate the outcome of a combination of surgical excision with Er: YAG laser ablation for treating CMNs. METHODS: A total of 13 patients were included in this study. The nevus was excised as much as possible and only dermal suturing was performed, without epidermal suturing, for the primary closure. We then ablated the whole lesion, including the suture lines, by using a dual-mode 2,940 nm Er:YAG laser with three to five passes. All the lesions were followed up for 6 months and they were evaluated with respect to the healing status, infection, erythema, scarring, textural change and pigmentary change. Subject satisfaction was scored at the 16th week by the patients. RESULTS: Eleven (83%) of the 13 patients were clinically rated as having a good to excellent result by the physicians' Global Assessment Scale (GAS) scores for the lesions' reduction of size, the degree of scarring and the pigmentary change with only a one stage procedure. 10 (77%) of the total 13 patients reported a good to excellent result at four months after treatment. CONCLUSION: A combination of surgical excision with Er:YAG laser ablation as a one stage procedure is a safe, effective modality and it should be considered as one of the options for treating medium-sized CMNs.
Subject(s)
Humans , Cicatrix , Cosmetics , Cryosurgery , Curettage , Dermabrasion , Erythema , Laser Therapy , Lasers, Solid-State , Melanoma , Nevus , Nevus, Pigmented , SuturesABSTRACT
BACKGROUND: There are various treatment options for congenital melanocytic nevus (CMN), including surgical excision, dermabrasions, curettage, laser treatment, chemical peels and cryosurgery. The proper choice of treatment depends on the size, location, thickness and clinical appearance of the nevi, the risk for developing melanoma, the psychological effect and the cosmetic component. OBJECTIVE: The purpose of this study is to evaluate the outcome of a combination of surgical excision with Er: YAG laser ablation for treating CMNs. METHODS: A total of 13 patients were included in this study. The nevus was excised as much as possible and only dermal suturing was performed, without epidermal suturing, for the primary closure. We then ablated the whole lesion, including the suture lines, by using a dual-mode 2,940 nm Er:YAG laser with three to five passes. All the lesions were followed up for 6 months and they were evaluated with respect to the healing status, infection, erythema, scarring, textural change and pigmentary change. Subject satisfaction was scored at the 16th week by the patients. RESULTS: Eleven (83%) of the 13 patients were clinically rated as having a good to excellent result by the physicians' Global Assessment Scale (GAS) scores for the lesions' reduction of size, the degree of scarring and the pigmentary change with only a one stage procedure. 10 (77%) of the total 13 patients reported a good to excellent result at four months after treatment. CONCLUSION: A combination of surgical excision with Er:YAG laser ablation as a one stage procedure is a safe, effective modality and it should be considered as one of the options for treating medium-sized CMNs.
Subject(s)
Humans , Cicatrix , Cosmetics , Cryosurgery , Curettage , Dermabrasion , Erythema , Laser Therapy , Lasers, Solid-State , Melanoma , Nevus , Nevus, Pigmented , SuturesABSTRACT
Acantholytic squamous cell carcinoma is a well-defined variant of squamous cell cancer in which significant portions of the neoplastic proliferation show a pseudoglandular or tubular microscopic pattern. It usually presents as a nodule with various colors, and it is accompanied by scaling, crusting, and ulceration on the sun-exposed areas of older aged individuals. Histologically, the tumor consists of a nodular, epidermal-derived proliferation that forms island-like structures. At least focally or sometimes extensively, the tumor cells shows a loss of cohesion within the central gland-like or tubular spaces. This tumor resembles the structure of eccrine neoplasms, but it is negative for dPAS, CEA and mucicarmine and it is only positive for EMA and cytokeratins. Herein we report a case of acantholytic squamous cell carcinoma that occurred on the face of an 82-year-old woman.
Subject(s)
Aged , Aged, 80 and over , Humans , Adenoids , Carcinoma, Squamous Cell , Carmine , Keratins , Neoplasms, Squamous Cell , Skin , UlcerABSTRACT
Lipomatous neurofibroma is a recently described, very rare variant of neurofibroma. It shows a well-circumscribed nodule consisting of fascicles or whorls of spindle cells with an extensive lipomatous component. These fat cells are considered to be an integral part of this tumor, not a metaplastic or degenerative process. It may be due to the differentiation of local stem cells of neural crest. Herein we report a case of lipomatous neurofibroma, the rare pathological variant of neurofibroma with extensive mature fat cells.
Subject(s)
Adipocytes , Neural Crest , Neurofibroma , Stem CellsABSTRACT
Hemochromatosis is a disorder of iron metabolism leading to irreversible damage to various organs due to progressive tissue iron overload. It is characterized by liver cirrhosis, heart failure, diabetes and skin pigmentation. In laboratory examinations, serum iron, ferritin, and transferrin saturation levels are markedly increased. Histologically, there are numerous cells containing brownish granules particularly around the sweat glands and these granules were positive for iron stain. We report a case of hemochromatosis in a 72-year-old woman with liver cirrhosis and diabetes, which is very rare in Asian populations.
Subject(s)
Aged , Female , Humans , Asian People , Ferritins , Heart Failure , Hemochromatosis , Iron , Iron Overload , Liver Cirrhosis , Pigmentation , Skin Pigmentation , Sweat Glands , TransferrinABSTRACT
BACKGROUND: Congenital melanocytic nevi may have various shapes according to the anatomic location. Therefore, it is desirable to apply proper surgical designs to the diverse forms considering the characteristics of the sites as well as the shape and size. OBJECTIVE: The purpose of this article is to introduce a new scar-saving flap design for semicircular defects after removing congenital melanocytic nevi without excising additional normal skin. METHODS: In most cases to excise semicircular nevi, normal skin should be excised to prevent dog ear, resulting in the long length of the scar. So we use a new scar-saving flap design by borrowing a partial length from the opposite side. RESULTS: We used this new technique for 4 cases of large semicircular skin defects. In all cases, this method had some advantages from this perspective: (1) it does not require excision of normal adjacent skin to convert a semicircular defect into a crescent shape or to remove dog-ears (2) the final suture line is not much longer than the diameter of the original defect and (3) it makes the removal of a much larger volume possible in one procedure rather than using the classic serial excision technique, which consists of a central elliptical excision within the confines of the nevus. In this way the frequency of procedures and discomfort to the patient can be reduced. CONCLUSION: We think that a scar-saving flap design by borrowing a partial length from the opposite side can be a good strategy for a semicircular skin defect.
Subject(s)
Animals , Dogs , Humans , Cicatrix , Ear , Nevus , Nevus, Pigmented , Skin , SuturesABSTRACT
BACKGROUND: Anxiety is a common disorder, but its diagnosis is often overlooked. Although there are several evaluating instruments, they are difficult to use in busy outpatient clinics because of its length. Furthermore, scales developed for screening are insufficient in the standardization. The purpose of this study is to measure reliability and validity of scale that can efficiently detect the anxiety patients in busy primary care setting. METHODS: With translation and assistance from psychiatrist, the questionnaire was developed. From March to July 2000, anxiety and control group at the department of family medicine in Seoul Joongang Hospital were tested with the questionnaire. After one week later, test was retaken. Reliability was verified by calculating Kappa value. Also validity was verified by comparing the scores between the anxiety group and the control group. Then sensitivity and specificity were evaluated, and the cutoff point was determined. RESULTS: Kappa values were ranging from 0.65 to 0.88. For each cutoff point 3, 4, 5, and 6 in total items, sensitivities were 99%, 97%, 82%, 64% and specificities were 55%, 75%, 94%, 98%, respectively. CONCLUSION: We translated an Goldberg's anxiety screening scale and estimated its reliability and validity. As the purpose was screening, we determined score 5 as the best cutoff points.
Subject(s)
Humans , Ambulatory Care Facilities , Anxiety Disorders , Anxiety , Diagnosis , Mass Screening , Primary Health Care , Psychiatry , Reproducibility of Results , Sensitivity and Specificity , Seoul , Weights and Measures , Surveys and QuestionnairesABSTRACT
During childhood, meningioma is an uncommon tumor, and in infants, extracranial meningioma is very rare. We report a case of primary cutaneous menigioma occurring on the scalp of a ten-month-old girl.
Subject(s)
Female , Humans , Infant , Meningioma , ScalpABSTRACT
BACKGROUND: Being obese during adolescence leads to undue physical or psychological problems and may increase the incidence of cardiovascular disease or endocrinological disorders. Recently authors have experienced a case of hyperinsulinemic obese girl with virilization. We report it with a review of the literature. CASE: A 17-year old female came into 'obesity clinic' of Asan Medical Center due to weight gain. She had virilizing feature, hirsutism, underdeveloped female sexual characteristics, and acanthosis nigricans. Work-up by laboratory tests and imaging studies showed very severe obesity with metabolic disturbances, and hyperandrogenism with hyperinsulinemia. Treatment for obesity was multidisciplinary method including behavior modification, calorie restriction, exercise, and medication with fluoxetine 40mg po qd, and for hyperandrogenism, provera 10mg po qd was described. CONCLUSIONS: Severe hyperinsulinemia in obese female leads to male-type hirsutism, disturbance of menstrual cycle, abdominal obesity, and cardiovascular disorders. One of the physical findings of hyperinsulinemia or insulin resistance is acanthosis nigricans. So, if an female obese patient have acanthosis nigricans with hyperinsulinemia, should be assessed and treated for risk factors of cardiovascular disorders and hormonal disturbances.