Causative agents and epidemiology of diarrhea in Korean native calves

Calf diarrhea caused by infectious agents is associated with economic losses in the cattle industry. The purpose of this study was to identify the causative agents and epidemiological characteristics of diarrhea in Korean native calves (KNC). In total, 207 diarrheal KNC aged less than 7 months were investigated. Fecal samples collected from the rectum were examined for causative agents using polymerase chain reaction (PCR) or real-time PCR and the number of oocysts were counted. Fourteen causative agents were detected from 164 of the 207 diarrheal KNC. Rotavirus was the most common agent (34.8%), followed by Eimeria spp. (31.7%), Escherichia coli (22.0%), Giardia spp. (14.0%), Clostridium difficile (9.8%), bovine viral diarrhea virus (8.5%), coronavirus (7.9%), Cryptosporidium spp. (7.3%), torovirus (6.7%), parvovirus (5.5%), norovirus (4.9%), kobuvirus (1.8%), adenovirus (1.2%), and Salmonella spp. (0.6%). About 95 (57.9%) of 164 calves were infected with a single causative agent and 42.1% were infected by multiple agents. No significant difference was observed in mortality between calves infected with a single agent and multiple agents. The occurrence of diarrhea caused by rotavirus, Eimeria spp., kobuvirus, and Giardia spp. was significantly different based on onset age, and the prevalence of diarrhea caused by rotavirus or C. difficile was significantly different between seasons. This study help the understanding of KNC diarrhea for the development of an effective strategy for disease prevention and control, especially in Eastern provinces of South Korea.

Bacterial and fungal organisms in otitis externa patients without fungal infection risk factors in Erzurum, Turkey / Organismos bacterianos e fúngicos em pacientes com otite externa sem fatores de risco para infecção fúngica em Erzurum, Turquia

AIM: To describe the bacterial and fungal organisms in otitis externa patients without other risk factors for fungal infections. STUDY DESIGN: Cross sectional cohort descriptive study. MATERIALS AND METHODS: Ear swabs were obtained from 362 patients aged 1 to 55 years old with clinically diagnosed otitis externa in Erzurum, Turkey, between January 2006 and April 2007, and cultured for aerobic and anaerobic bacteria and fungi, using EMB, 5 percent sheep's blood, chocolate agar, anaerobic blood agar plate, thioglycollate broth and sabaroud agar using standard microbiological technique to diagnose isolates. RESULTS: 219 cultures were positive and a total of 267 isolates were obtained. Of the isolates, 68.16 percent (n: 182) were aerobic or facultative bacteria, 1.12 percent (3) were anaerobic bacteria, 30.71 percent (82) were fungi and 17.5 percent (38) were polymicrobial infections. CONCLUSION: Fungal organisms especially Candida species may be isolated from ears of otitis externa patients without fungal infection risk factors such as ear self-cleaning, local antimicrobial, antifungal or corticosteroid drops or systemic antimicrobial or antifungal agents within the preceding week. Bacterial and fungal cultures may be recommended, and anti-fungal agents may be added, to treatment regimens in patients with otitis externa.

OBJETIVO: Descrever fungos e bactérias presentes em pacientes com otite externa sem fator de risco para infecções fúngicas. FORMA DE ESTUDO: Estudo descritivo de coorte transversal. MATERIAIS E MÉTODOS: Amostras por raspagem de cotonetes (swabs) no ouvido foram obtidas de 362 pacientes com idades entre 1 e 55 anos, com diagnóstico clínico de otite externa em Erzurum, Turquia, entre janeiro de 2006 e abril de 2007. Essas amostras foram cultivadas em meio de cultura, 5 por cento de sangue de ovelha, ágar chocolate, ágar sangue anaeróbio, banho em tioglicolato e ágar Saboroud, usando técnicas padrão de microbiologia para identificar os isolados. RESULTADOS: Obtivemos 219 culturas positivas e 267 isolados. Dos isolados, 68,16 por cento (n: 182) eram bactérias aeróbias ou facultativas, 1,12 por cento (3) eram bactérias anaeróbias, 30,71 por cento (82) eram fungos e 17.5 por cento (38) eram germes polimicrobianos. CONCLUSÃO: Fungos, especialmente espécies de Candida podem ser encontradas em ouvidos de pacientes com otite externa sem fatores de risco para infecção fúngica tais como autolimpeza do ouvido, uso de antimicrobiano local, corticosteroides ou antifúngicos tópicos ou agentes antibacterianos e antifúngicos sistêmicos na semana anterior. Culturas de bactérias e fungos podem ser recomendadas, e agentes antifúngicos podem ser acrescentados a esquemas de tratamento de pacientes com otite externa.

Artritis séptica y osteomielitis aguda en pediatría / Septic artritis and acute osteomielitis in pediatrics

Objective: To review the clinical presentation, the organisms responsible for arthritis and acute osteomyelitis and the intrahospitalary and ambulatorie management in childhood less than 16 years in the post Haemophilus influenza tipe B vaccine era. Methods: Retrospective review of clinic case account in the Hospital Clínico de la Pontificia Universidad Católica in the period from January 2004 to July 2008 with the diagnosis of acute infection oteomyelitis and septic arthritis. There were include all the cases, with or without surgical management and intra and extra hospitalary infection source. Results: There were 32 total cases, 22 acute osteomyelitis (AOM) and 16 septic arthritis (SA). Pain and functional impotence of lower limbs, were the 2 first sintoms. The agent was isolated in 25 percent of the SA and 54.5 percent of the AOM. The most frecuent isolated agent in AOM was the Staphilococcus aureus. In SA, there was no isolated this agent. Discussion: The clinical findings of the osteoarticular infections (OAI), presents with a loss florid illness than the classical presentation. To know the agent take time. For that reason, we thought that the empirical intravenosus antibiotical treatment is fundamental in this knew studies about this matter, that can propuose an universal empyric antibiotic therapy.

Objetivo: Revisar la presentación clínica, microorganismos responsables de artritis séptica (AS) y de osteomielitis aguda (OM), así como el manejo agudo y seguimiento en población pediátrica menor de 16 años en la era post vacuna anti Haemophilus influenzae tipo B (Hib). Métodos: Revisión retrospectiva de casos clínicos acontecidos en nuestro Hospital entre los años 2004 y 2008 con el diagnóstico de OM y AS de origen infeccioso. Se incluyeron todos los casos registrados, con o sin manejo quirúrgico, y con fuente infecciosa tanto intra como extra hospitalaria. Resultados: Se obtuvo ficha clínica completa en 38 casos, 22OMA y 16 AS. El dolor y la impotencia funcional de extremidades inferiores, fueron los principales motivos de consulta en ambos grupos. Se logró aislar el agente en un 25 por ciento de las AS y un 54,5 por ciento de las OMA. El microorganismo más frecuente en OMA fue el Staphilococcus aureus. No se aisló este mismo, en AS. Discusión: La presentación clínica inicial de las infecciones osteoarticulares (IOA), es menos evidente en la actualidad que en otros tiempos. Debido a que la identificación del microorganismo causante de la infección no es inmediata, pensamos que la terapia antibiótica (ATB) empírica inicial es fundamental en el manejo de estas patologías. Sugerimos nuevos estudios que propongan un determinado manejo ATB empírico inicial universal.

Pancreatic Exocrine and Endocrine Cell Differentiation during Pancreatic Regeneration / 한양의대학술지

Pancreatic tissue is maintained by a simple proliferation of the preexisting cells in adulthood, whereas, they are dynamically derived from precursor/ stem cells from ductal epithelia during prenatal life. It has been known that tissue regeneration rarely occurs in the normal adult pancreas, particularly in the human pancreas. However, regeneration can be experimentally induced in the adult pancreas in response to various tissue injuries such as partial resection, pancreatitis by obstruction of the duct, and chemical insults. Regenerating pancreatic tissue shares a common morphogenic feature of "neogenic regeneration" in all regenerating animal models. Neogenic regeneration occurs at the site of tissue injury by forming small tubular structures with elongated epithelial cells (ductules) which grow to form pancreatic ducts and acini. The endocrine cells, including insulin secreting beta cells, are also derived from these ductules. As a sequential process of neogenesis, the regenerating tissue becomes heterogeneous in composition. Some areas were composed by tubules and ductules in surrounding loose connective tissue while others were denser with differentiating acini derived from tubules or ductules. Such neogenic regeneration mimics tissue development during fetal pancreatic organogenesis. In the process of pancreatic neogenesis, we found unique expressions of bioactive proteins such as nestin and clusterin as morphogenic factors. It is likely that the stem/precursor cells could be recapitulated and regenerated to functional cells, including endocrine and exocrine pancreatic cells with acinar and ductal cells during neogenic regeneration of the pancreas.

Changing Patterns of Dermatophytosis and Its Causative Agents according to Social and Economic Developments in Korea / 대한의진균학회지

Deramtophytosis is one of common dermatoses and occupied 10~20% of all dermatologic outpatients in Korea. It has close relationship between host (human) and dermatophytes. Their clinical patterns and incidence, and their causative dermatophytes may change with social environments and life patterns; Some dermatophytes may decrease or disappear and others can be imported from other countries. During recent 60 years, GNP has been increased explosively, more than 190 folds, and that economic developments brought abrupt changes of social environments and life patterns in Korea. Furthermore, there had been great social events; Korean War in 1950~1953, the Asian Game in 1986, the Olympic Game in 1988 and the World Cup in 2002. Those events gave much chances for dermatophytes to move and change. Trends of clinical types of dermatophytosis and their causative dermatophytes were evaluated with reported articles during the period. Tinea capitis showed the most dramatic changes. Its incidence was the highest just after Korean war, 24.5% of all primary school students, and decreased abruptly by 26.5% of all dermatophytosis in late 1950s, 4.9% in late 1960s, and 2~4% since 1970s. Microsporum(M.) ferrugineum was the most common isolates till 1970s, and abruptly decreased and now nearly disappeared. Trichophyton(T.) violaceum was isolated in Cheju island. After Korean war, T. schoenleinii was isolated from favus and disappeared. M. canis was isolated for the first time in 1959 and has been the most common isolates from tinea capitis since late 1970s. T. verrucosum was isolated for the first time in 1986 in Kwangju and has been isolated nation-widely. T. tonsurans was isolated for the first time in 1995 in Daegu and spread among wrestlers, Judo players and Korean wrestlers. It might be imported by wrestlers with sport exchanging program. Tinea pedis is the most common dermatophytosis in Korea now. It was 26% of all dermatophytosis in late 1950s, and increased by 40.9~42.2% in 1970s. And tinea unguium has been increased as tinea pedis does; It was 2.8% of all dermatophytosis in late 1950s, and increased by 5.1~14.2% in 1970s, 5.5~15.3% in 1870s and 17% in 1990s. The patiets with tinea pedis have high family infection and also high coexisting dermatophytosis. The most common isolate was T. rubrum, followed by T. mentagrophytes and Epidermophyton floccosum. Tinea cruris was one of dramatically changed dermatophytosis. Its incidence was 5% of all dermatophytosis in 1940s, and increased by 10.2% in late 1950s, and 26.6~39.1% in 1970s. Environments and socioeconomic conditions are changing, and international travel and sports exchanging program are increasing. All those social events may cause new dermatophytes to invade from other countries. We should check it carefully and continuously.

Superficial Cutaneous Mycoses in Korea / 한양의대학술지

Superficial cutaneous mycosis is mycotic infection of the epidermis of the skin, and one of common dermatoses in Korea. They have close relationship between host (human) and fungi. Their clinical patterns and incidence, and their causative fungi may change with social environments and life patterns. Since 1945, GNP has been increased explosively, more than 243 folds, and economic developments brought abrupt changes of social environments and life patterns in Korea. Furthermore, there had been great social events during this period; Korean War in 1950-1953, the Asian Game in 1986, the Olympic Game in 1988 and the World Cup in 2002. Those events gave much chances for dermatophytes to move and change. Tinea pedis is the most common dermatophytosis and has been increased from 26% of all dermatophytosis in late 1950s to 40.9-42.2%. And tinea unguium(onychomycosis) has been increased as tinea pedis does; Its proportion was 2.8% in late 1950s, and 17% in 1990s. The patients with tinea pedis have high family infection rate and also have high coexisting dermatophytosis. The most common isolate was Trichophyton(T.) rubrum, followed by T. mentagrophytes and Epidermophyton floccosum. Tinea capitis showed the most dramatic changes; its incidence was the highest just after Korean war and decreased abruptly since 1970s. Microsporum(M.) ferrugineum was the most common isolates till 1970s, and abruptly decreased and now nearly disappeared. Trichophyton(T.) violaceum was isolated in Cheju island. After Korean war, T. schoenleinii was isolated from favus and is disappeared. M. canis was isolated for the first time in 1959 and has been the most common isolates since late 1970s. T. verrucosum was isolated in 1986, and T. tonsurans was isolated for the first time in 1995 and spread among wrestlers, Judo players and Korean wrestlers. It might be imported by wrestlers with sport exchanging program. In cidence of tinea cruris was dramatically changed and was 5% of all dermatophytosis in 1940s, and 26.6-39.1% in 1990s. Those changes might be related to change of life patterns. Proportion of cutaneous candidiasis among superficial cutaneous mycosis was 1.9% in 1960s, 6.7% in 1973, 14.6% in 1976-1985, and 7.4% in 1989-1992. Proportion of pityriasis versicolor among superficial cutaneous mycosis was 12.1% in 1973, 7.7% in 1976-1985, and 7.7% in 1989-1992. Research for Malassezia have been increasing since late 1990s and that will bring us many new informations.

A Mycological Study of Onychomycosis / 대한의진균학회지

For the sake of simplicity, it is as well to divide nail pathogens into dermatophytes (moulds) and yeasts. Most dermatophyte infections of nails, some over 80% are caused by Trichophyton rubrum (T. rubrum), with Trichophyton mentagrophytes (T. mentagrophytes) found in around 10% of cases. Occasionally there are mixed or pure infections with yeast mostly Candida albicans. Rarely nondermatophytic fungi such as Scopolariopsis, Aspergillus, Scytalidium and Fusarium species are found to be causative agents in onychomycosis. Importance of accurate diagnosis of onychomycosis has been increasing because more than half of the patients with nail disorders are non-onychomycotic. Direct smear with KOH is the most simple and valuable laboratory test which will takes about 20 to 30 minutes. the positive rate of direct smear is relatively high (40~60%), but permanent keeping of the positive microscopic findings is not possible. Fungus culture is the most essential laboratory test for identifying the species of the causative fungi even though the positive rate is low (20~50%) and takes 3 to 4 week to have the result. Histopathologic test is a non-invasive diagnostic method with high positive rate (70~90%). The test is very helpful for confirming the mixed infection of the onychomycosis. KONCPA test abbreviated by "melting with KOH of the nail clippings and PAS staining" is a new diagnostic method. Though the test requires some skill and equipments, the positive rate is high (70~90%) and permanent keeping of the positive findings is possible.

Superficial Dermatomycosis and the Causative Agents in Korea / 대한의진균학회지

Dermatophytes invades and destroys keratinized tissue of the skin, hairs and nails by keratinase. The prevalence and clinical characteristics of dermatomycosis are changed under the various influences such as geographic factor, social environment and development of therapy. Infections caused by some 10 species of dermatophytes isolated since 1924 in Korea. There was a general rise in the cases of Trichophyton (T.) rubrum infections and in recent years the prevalence of Microsporum (M.) canis infections has markedly increased but those of M. ferrugineum have decreased. The yeasts of genus Malassezia are dimorphic and lipophilic and are numbers of the normal flora in humans. Malassezia yeasts are implicated in various diseases, including pityriasis versicolor, Malassezia folliculitis, seborrheic dermatitis and systemic fungal infections.