A Study of Respiratory Syncytial Virus Outbreak at Postpartum Care Center in Busan, Korea

Respiratory syncytial virus (RSV) is common cause of acute respiratory infection in infants and young children. Group life in postpartum care centers is easily exposed to infectious diseases in neonates and puerperds immediately after giving birth, and the harm caused by exposure to them is much greater. In particular, respiratory diseases are highly infectious and infections occur in a short period of time. among them, RSV infections are very serious in children under 5 years of age, leading to death. This paper studied an infection of RSV in outbreaks at postpartum care center in Busan. In 4 postpartum care centers, a total of 877 people (390 neonates, 386 puerperds, 106 others) were exposed to RSV outbreak. Of these, there were 73 RSV-positive patients; most of them had cough and runny nose and no fever. We were collected from neonates and puerperds with acute respiratory tract a total of 146 samples (throat swabs). In 51 samples, RSV (43 cases), human rhinovirus (6 cases), human coronavirus NL63 (1 case), and human coronavirus 229E (1 case) were found to be positive and the rest were negative. All 43 RSV positive samples were identified as RSV B. Sequence analysis of the detected strains was performed to confirm the molecular genetic information of RSV. Out of 43 RSV positive samples, 38 samples were successfully sequenced using the G gene, resulting in all of the same genotype BA9. This study provides a better understanding of RSV prevalence patterns and genetic characteristics. It also contributes to the accumulation of epidemiological data and the development of public health and hygiene.

Distribution and Characterization of Airborne Respiratory Pathogens in Public Facilities

Respiratory infections, which are caused by airborne pathogens, are the most common disease of all ages worldwide. This study was conducted to characterize the airborne respiratory pathogens in the public facilities in Busan, South Korea. A total of 260 public facilities were investigated in 2017, 52 seasonal indoor air from 2 hospitals and 208 indoor air samples from 208 randomly selected daycare centers. Among respiratory pathogen, 8 viral pathogens including human adenovirus (HAdV), human bocavirus (HBoV), human rhinovirus (HRV), human parainfluenza virus (HPIV), human respiratory syncytial virus (HRSV), human metapneumovirus (HMPV), human coronavirus (HCoV) and influenza virus (IFV), and 3 bacterial pathogens including Mycoplasma pneumoniae, Bordetella pertussis, and Chlamydophila pneumoniae, were investigated by multiplex real-time reverse transcription polymerase chain reaction. Pathogens were detected in 9 cases (3.4%). Among 9 positive samples, 6 (2.3%) cases were positive for HBoV and 3 (1.2%) cases were positive for IFV. All the positive cases were detected in daycare centers. Additionally, the concentration of HBoV was determined. In HBoV-positive samples, the cycle threshold (Ct) values of HBoV were 29.73~36.84, which are corresponding to the viral concentration of 4.91 × 10⁰ ~ 9.57 × 10² copies/ml. Serotype distribution of isolated HBoV was analyzed by sequencing of VP1/VP2 gene. All of the HBoV isolates were identified as HBoV type 1 with a high similarity among the isolates (>97%). No bacterial pathogen was identified in indoor air samples. Although virus concentration was not high in public facilities (daycare center), the presence of respiratory viral pathogens has been identified. Effective ventilation and air purification strategies are needed to reduce the indoor concentration of respiratory pathogens. A long-term and ongoing surveillance plan for respiratory pathogen management should be established.

Study on Causes of Respiratory Disease to the Middle East Respiratory Syndrome-negative Subjects

Middle East respiratory syndrome coronavirus (MERS-CoV) causes severe cases of human respiratory disease. The current outbreak of infection with this virus in South Korea, which began on May 20, 2015, has infected 186 patients and caused 36 deaths within 2 months. In this study, to investigate the viral pathogen causing acute respiratory infections, multiplex/RT-PCR was performed on were obtained from nucleic acid of the Middle East Respiratory Syndrome-negative subjects. Viruses and atypical bacteria were detected in 39 of 337 (11.6%). Frequent viruses were human rhinovirus (n=11, 3.3%), human metapneumovirus (n=9, 2.7%), parainfluenza (n=9, 2.7%) and adenovirus (n=4, 1.2%). Mycoplasma pneumonia (M. pneumonia) was detected in 1.8 % (n=6). Out of 9 human metapneumovirus (hMPV) positive samples, 6 samples were successfully sequenced using F gene. And M. pneumoniae was sequencing of a repetitive region of the P1 gene. Phylogenetic analysis revealed that hMPV clustered into A2b lineage (n=4), B2 lineage (n=2) and M. pneumoniae clustered into two genotypes: Type 1 (n=4), Type 2a (n=2).

Study on Causes of Respiratory Disease to the Middle East Respiratory Syndrome-negative Subjects

Middle East respiratory syndrome coronavirus (MERS-CoV) causes severe cases of human respiratory disease. The current outbreak of infection with this virus in South Korea, which began on May 20, 2015, has infected 186 patients and caused 36 deaths within 2 months. In this study, to investigate the viral pathogen causing acute respiratory infections, multiplex/RT-PCR was performed on were obtained from nucleic acid of the Middle East Respiratory Syndrome-negative subjects. Viruses and atypical bacteria were detected in 39 of 337 (11.6%). Frequent viruses were human rhinovirus (n=11, 3.3%), human metapneumovirus (n=9, 2.7%), parainfluenza (n=9, 2.7%) and adenovirus (n=4, 1.2%). Mycoplasma pneumonia (M. pneumonia) was detected in 1.8 % (n=6). Out of 9 human metapneumovirus (hMPV) positive samples, 6 samples were successfully sequenced using F gene. And M. pneumoniae was sequencing of a repetitive region of the P1 gene. Phylogenetic analysis revealed that hMPV clustered into A2b lineage (n=4), B2 lineage (n=2) and M. pneumoniae clustered into two genotypes: Type 1 (n=4), Type 2a (n=2).

Characteristics of Respiratory Syncytial Virus isolated from Acute Respiratory Infectious Disease in Busan

Human respiratory syncytial virus (HRSV) is known as the leading cause of respiratory tract illness in infancy and elderly children worldwide. We investigate the prevalence pattern and genetic characteristics in the second variable region G protein gene of HRSV during 5 consecutive seasons from 2010 to 2015. A total of 4,793 specimens (throat swabs) were collected from patients with acute respiratory tract. HRSV were evaluated and classified as HRSV A (n=111) or HRSV B (n=64) by real-time RT-PCR or RT-PCR. In general HRSV were detected in winter season. Coughing, fever, rhinorrhea and sputum were confirmed main symptoms in patients with HRSV. There were no significant differences in clinical characteristics or severity according to the HRSV subgroup infections. Out of 175 HRSV positive samples, 94 samples were successfully sequenced using G gene. Phylogenetic analysis revealed that 62 HRSV-A strains clustered into genotypes ON1 (n=54, 87.1%), NA1 (n=7), NA2 (n=1) and 32 HRSV-B strains clustered into three genotypes: BA4 (n=28, 87.5%), BA5 (n=2), BA6 (n=2). These results provide a better understanding of HRSV prevalence pattern and genetic characteristics.

Generation and characterization of integration-free induced pluripotent stem cells from patients with autoimmune disease

Autoimmune diseases (AIDs), a heterogeneous group of immune-mediated disorders, are a major and growing health problem. Although AIDs are currently treated primarily with anti-inflammatory and immunosuppressive drugs, the use of stem cell transplantation in patients with AIDs is becoming increasingly common. However, stem cell transplantation therapy has limitations, including a shortage of available stem cells and immune rejection of cells from nonautologous sources. Induced pluripotent stem cell (iPSC) technology, which allows the generation of patient-specific pluripotent stem cells, could offer an alternative source for clinical applications of stem cell therapies in AID patients. We used nonintegrating oriP/EBNA-1-based episomal vectors to reprogram dermal fibroblasts from patients with AIDs such as ankylosing spondylitis (AS), Sjögren's syndrome (SS) and systemic lupus erythematosus (SLE). The pluripotency and multilineage differentiation capacity of each patient-specific iPSC line was validated. The safety of these iPSCs for use in stem cell transplantation is indicated by the fact that all AID-specific iPSCs are integrated transgene free. Finally, all AID-specific iPSCs derived in this study could be differentiated into cells of hematopoietic and mesenchymal lineages in vitro as shown by flow cytometric analysis and induction of terminal differentiation potential. Our results demonstrate the successful generation of integration-free iPSCs from patients with AS, SS and SLE. These findings support the possibility of using iPSC technology in autologous and allogeneic cell replacement therapy for various AIDs, including AS, SS and SLE.

Meta-analysis about the Effectiveness of Intervention Programs for Married Immigrant Women

PURPOSE: The purpose of this study was to test the effect size of intervention programs for married immigrant women as well as to suggest the basic data for health care practices for married migrant women. METHODS: Meta-analysis was conducted with 27 articles from domestic Korea master's and doctorate degree dissertations and Korea academic journals from 2007 to 2014. RESULTS: Overall average effect size was 1.17 and 'parental education' of Intervention Variables was the biggest effect size. Intervention Variables were also identified to be the most desirable in cases when total sessions were applied with 10-18 sessions, 1 session per week, 90-120 minutes per session activity time and with less than 10 subjects in group size. Regarding effect variables, psychological variable group was identified to show the biggest effect size and in sub-variables, self-efficacy was identified to show the biggest effect size. CONCLUSION: If intervention programs for married immigrant women is expanded and conducted based on the results of this study, the program would have significant affect psychological, social and physical health of the married migrant women who currently occupy the important status in our society.

A Study on Nursing Students' Self-leadership and Their Perception of Learning / 한국간호교육학회지

PURPOSE: The purpose of this study was to identify the relationship between self-leadership and the perception of learning in nursing students. METHODS: A descriptive research design was used in this study. The participants were 378 nursing students in M city and C city who were surveyed between June 1 and June 30, 2014 using self-report questionnaires. The data was analyzed using SPSS WIN 21.0 Program, which determined frequency, percentage, mean, standard deviation; a One-way ANOVA; a Scheffe test; a Pearson correlation coefficient; and a Stepwise multiple regression analysis. RESULTS: There were significant positive correlations between nursing students' self-leadership and their perception of learning. In the multiple regression analysis, self-leadership was the most significant predictor in explaining nursing students' perception of learning. CONCLUSION: Study findings suggest that nursing students' self-leadership is defined as having an important influence on nursing students' perception of learning. In order to strengthen nursing students' self-leadership, there is a need to develop education programs that increase nursing students' self-leadership.

A Study on Satisfaction with Mental Health Services and Quality of Life among Patients with Schizophrenia in the Community Mental Health Center / 대한정신분열병학회지

OBJECTIVES: The purpose of this study was to investigate client satisfaction with mental health services across sociodemographical and service utilization characteristics and to identify the predictors for quality of life for schizophrenic patients who registered in community mental health center. METHODS: One hundred five schizophrenic patients who had received intensive or continuing care completed questionnaires, which included Consumer Satisfaction Scale and the Korean version of World Health Organization Quality of Life Assessment Instrument-Brief (WHOQOL-BREF). Subject's sociodemographic and service utilization characteristics were compared using t-test or one-way analysis of variance. To examine the influence of these variables on quality of life, stepwise multiple regression was conducted. RESULTS: Consumer satisfaction scores differed significantly depending on the length of contact with a current mental health staff. In a stepwise multiple regression model, service relevance and occupation together explained 20.5% of variance in quality of life. CONCLUSION: The results suggest that continuity in contact with a current mental health staff was important in consumer satisfaction. Service relevance and occupation had an impact on quality of life.

The Association between Economic Status and Depressive Symptoms: An Individual and Community Level Approach

OBJECTIVE: The study was conducted to investigate the association between economic status and depressive symptoms by comparing the prevalence rates of depressive symptoms at community level and analyzing the possibility of depressive symptoms at individual level. METHODS: A survey was conducted from November, 2006 to November, 2007 on 966 and 992 representative subjects recruited by stratified clustered sampling in two regions located in Seoul. We used a standardized questionnaire including the Center for Epidemiologic Studies-Depression and questions on the socioeconomic characteristics. The adjusted prevalence rates of depressive symptoms were compared at community level, and multiple logistic regression analysis was performed to determine the association between depressive symptoms and economic statuses at individual level among each region. RESULTS: The adjusted prevalence of depressive symptoms was higher in the region with a high socioeconomic status (23.1%) than in the region with a lower economic status (16.6%)(p<0.001). However, logistic regression analysis of individual level revealed that a higher economic status was significantly associated with a lower possibility of depressive symptoms among the females in the low economic status region. This tendency was not observed among the males in both of the regions. CONCLUSION: The association between economic status and depressive symptoms was found to be different when it was approached at community level or individual level. In addition, the association of two variables was different by gender at individual level. Further studies that consider the third mediators are needed to determine the association between the two variables.

A Case of Primary Cutaneous Endometriosis at the Unbilicus / 대한산부인과학회지

Cutaneous endometriosis seems to be more common in women who have had a pelvic or abdominal operation and primary cutaneous endometriosis is very rare. In our hospital we experienced a 41-year-old woman who complained of the appearance at the umbilicus of a nodule and had not had operation. This nodule was responsible for recurrent pain and increasing in size and it was excised. Pathology findings revealed cutaneous endometriosis. So we present a case of primary cutaneous endometriosis with a brief review of literature.

Jejunostomy-Site Adenocarcinoma: A case report

Malignant tumors of the small bowel are uncommon by comparison with those in other parts of the gastrointestinal tract. Adenocarcinomas account for about half of the malignant tumors of the small intestine, which account for 1% to 2% of the gastrointestinal neoplasma. Small-bowel tumors are often asymptomatic and without clinical significance, and later became symptomatic and are eventually fatal. Patient's with regional enteritis, especially those who have had segments of the intestine surgically by passed, have an increased incidence of small-bowel cancer. The author experienced a case of an adenocarcinoma at the jejunostomy site (Braun anastomosis) which was treated by using a B II type subtotal gastrectomy for stomach cancer. That case of a jejunostomy site adenocarcinoma is reported and the literature on small-bowel malignancy is reviewed.

A Retrospective Analysis and Clinical Review of Fistula-in-Ano

PURPOSE: The results for treatment of fistula-in-ano have much improved, along with the development of anatomical knowledge, classification, and operative techniques, during last several decades. The authors retrospectively reviewed the results for treatment of fistula-in-ano, especially complex fistulas, during the last 11 years. METHODS: A retrospective study of fistula-in-ano was performed for 229 patients who had been operated on in St. Benedict Hospital between January 1988 and December 1998. Complex fistulas (IIH, III & IV) were analyzed separately. RESULTS: The most common type was IILs (92 cases, 40.2%), and the most common horseshoe type was IIIBc (5 cases, 2.2%). The average hospital stay was 11.5 days for all fistula-in-ano types, but 15.1 days for complex fistulas. Non-specific inflammation (209 cases, 91.3%) was the most common pathologic finding. Various operative procedures were used : fistulotomy (80 cases, 34.9%), fistulectomy (74 cases, 32.3%), coring out fistulectomy (63 cases, 27.5%), seton technique (11 cases, 4.8%), and muscle-filling technique (1 case, 0.4%). There was no difference in the recurrence rate among the operative types. Various procedures were tried for complex fistulas, but the sphincter-preserving fistulectomy by Takano seemed to have a low recurrence rate and a short postoperative course. However, because of the small number of cases, this difference in recurrence rate and postoperative course was not statistically significant. The overall postoperative complication rate was 7%: anal infection (4 cases, 1.7%), anal bleeding (3 cases, 1.3%), and urinary retention (2 cases, 0.9%). CONCLUSIONS: The operations for most of the fistulae, IH, IL & IIL, were simple and uneventful. However, the operations for complex fistulae were complicated and more skill was required. We have thought Takano's operation to be a good curative procedure with less postoperative deformity and shortened postoperative course. However this research couldn't prove that with statistical significance, probably because of the insufficient number of patients. If further cases are collected and continuous follow-up is done, then a better result can be expected.