Evaluation of COVID-19 vaccine effectiveness in different high-risk facility types during a period of Delta variant dominance in the Republic of Korea: a crosssectional study

Objectives@#We evaluated the effectiveness of coronavirus disease 2019 vaccination in high-risk facilities in the Republic of Korea during the period when the highly transmissible Delta variant was prevalent. Additionally, we aimed to explore any disparities in vaccine effectiveness (VE) across various types of institutions, specifically distinguishing between non-medical and medical establishments. @*Methods@#We examined 8 outbreak clusters covering 243 cases and 895 contacts from 8 highrisk facilities divided into 2 groups: group A (4 non-medical institutions) and group B (4 medical institutions). These clusters were observed from July 27, 2021 to October 16, 2021 for the attack rate (AR) and VE with respect to disease severity. A generalized linear model with a binomial distribution was used to determine the odds ratio (OR) for disease severity and death. @*Results@#AR was notably lower in group B (medical institutions). Furthermore, VE analysis revealed that group A exhibited higher effectivity for disease severity and death than group B. The OR for disease severity was 0.24 (95% confidence interval [CI], 0.03–2.16) for group A and 0.27 (95% CI, 0.12–0.64) for group B, with the OR for death at 0.12 (95% CI, 0.01–1.32) in group A and 0.34 (95% CI, 0.14–0.87) in group B. @*Conclusion@#Although VE may vary across institutions, our findings underscore the importance of implementing vaccinations in high-risk facilities. Customized vaccination programs, tailored response plans, and competent management personnel are essential for effectively addressing and mitigating public health challenges.

A Case Report of Human Brucellosis Found by Zoonoses Surveillance System Based on One Health / 農村醫學 地域保健

Brucellosis is one of the zoonoses, and it is a disease that is almost eliminated in South Korea. This disease is also known as a representative disease of one health. We would like to introduce brucellosis found by one health in this study. One Health means an approach in which multiple sectors communicate and work together to achieve better public health outcomes. The Gyeongbuk Agricultural Safety and Health Center established a cooperation system between a Veterinary Service Laboratory and a Public Health Center, and found a case of human brucellosis in a farm with cattle brucellosis. Through this case, to be effective control of zoonoses as above case, epidemiological investigation for cattle and human should be concurrently conducted. And we once again recognized the need for multi-sectoral cooperation in prevention and management of zoonoses.

A Study on the Febrile Illness in Autumn among Farmers in Gyeongju-si: Scrub typhus, Leptospirosis, HFRS / 農村醫學 地域保健

OBJECTIVES: This study aimed to assess the status of Scrub typhus, Leptospirosis and HFRS(hemorrhagic fever with renal syndrome) among farmers with febrile illness. METHODS: We involved a total of 841 farmers who had febrile illness(508 and 333 village residents were, respectively, three and four district of Gyeongju city) selected during autumn of 2014 and 2015. Data were collected by survey questionnaires and blood sample examination. RESULTS: Serum response rate for Scrub typhus and Leptospirosis was 1.5% each and 1.9% for HFRS. Serum response rate for Scrub typhus was significantly higher for tick-bite cases(38.5%), while Leptospirosis was significantly higher for those who were in fruit–planting work(23.1%). Similarly, serum response rate was significantly higher for HFRS who were working in venyl green house work(25.0%). CONCLUSIONS: Government authority should develop effective and efficient preventive strategies to create awareness of infectious diseases among farmers. Extending information, education and communication be reached to farmers that could change their perception and help early diagnosis and treatment and reduce the disease burden and its complication.

Status and Awareness of Excessive Heat Exposure among Agricultural Workers / 農村醫學 地域保健

OBJECTIVES: This study was to assess the status and awareness of excessive heat exposure among agricultural workers. METHODS: We selected a total of 90 farmers from a villages of Gyeongju-si, during August, 2015. We carried out the temperature measurement for nine times and derived Health Index (HI) and Wet Bulb Globe Temperature (WBGT) index. We compared the HI, WBGT and excessive heat warnings. Status of high temperature exposure, lifestyle, medical history, and awareness about excessive health related exposure illness assessed using survey questionnaires. RESULTS: The matching rates between the WBGT and the HI during excessive heat warning were high, but when it was a non-excessive heat warning, there were days of excessive HI or WBGT. Out of 90 farmers surveyed, 78 cases (86.7%) were in their 60s and older age group. Slightly more than two third (71.1%) farmers were farming in the dawn-morning (71.1%), and the daily working hours were less than 4 hours (54.4 %), but only 23.3% among farmers took regular breaks. Of total, 14.4% farmers experienced excessive heat exposure related illness in order of tiredness, lethargy, dizziness, headaches, and sweating. Overall, the awareness of the danger for excessive heat and the heat wave warnings were high at 70.0% and 74.4%, respectively. CONCLUSIONS: Politically, the excessive heat warnings should not be taken into account the simple temperature measurement but, have to consider WBGT and HI standards at the same time. Farmers need to be promoted and educated to prevent the excessive heat related illness by periodically increasing their rest time during farming.

Hepatotoxicity and nephrotoxicity of saponin-enriched extract of Asparagus cochinchinensis in ICR mice / 한국실험동물학회지

The inhibitory effects of Asparagus cochinchinensis against inflammatory response induced by lipopolysaccharide (LPS), substance P and phthalic anhydride (PA) treatment were recently reported for some cell lines and animal models. To evaluate the hepatotoxicity and nephrotoxicity of A. cochinchinensis toward the livers and kidneys of ICR mice, alterations in related markers including body weight, organ weight, urine composition, liver pathology and kidney pathology were analyzed in male and female ICR mice after oral administration of 150, 300 and 600 mg/kg body weight/day saponin-enriched extract of A. cochinchinensis (SEAC) for 14 days. The saponin, total flavonoid and total phenol levels were found to be 57.2, 88.5 and 102.1 mg/g in SEAC, respectively, and the scavenging activity of SEAC gradually increased in a dose-dependent manner. Moreover, body and organ weight, clinical phenotypes, urine parameters and mice mortality did not differ between the vehicle and SEAC treated group. Furthermore, no significant alterations were measured in alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), blood urea nitrogen (BUN) and the serum creatinine (Cr) in the SEAC treated group relative to the vehicle treated group. Moreover, the specific pathological features induced by most toxic compounds were not observed upon liver and kidney histological analysis. Overall, the results of the present study suggest that SEAC does not induce any specific toxicity in the livers and kidneys of male and female ICR mice at doses of 600 mg/kg body weight/day.

Therapeutic effect of ethyl acetate extract from Asparagus cochinchinensis on phthalic anhydride-induced skin inflammation / 한국실험동물학회지

Asparagus cochinchinensis has been used to treat various diseases including fever, cough, kidney disease, breast cancer, inflammatory disease and brain disease, while IL-4 cytokine has been considered as key regulator on the skin homeostasis and the predisposition toward allergic skin inflammation. However, few studies have investigated its effects and IL-4 correlation on skin inflammation to date. To quantitatively evaluate the suppressive effects of ethyl acetate extracts of A. cochinchinensis (EaEAC) on phthalic anhydride (PA)-induced skin inflammation and investigate the role of IL-4 during their action mechanism, alterations in general phenotype biomarkers and luciferase-derived signals were measured in IL-4/Luc/CNS-1 transgenic (Tg) mice with PA-induced skin inflammation after treatment with EaEAC for 2 weeks. Key phenotype markers including lymph node weight, immunoglobulin E (IgE) concentration, epidermis thickness and number of infiltrated mast cells were significantly decreased in the PA+EaEAC treated group compared with the PA+Vehicle treated group. In addition, expression of IL-1β and TNF-α was also decreased in the PA+EaEAC cotreated group, compared to PA+Vehicle treated group. Furthermore, a significant decrease in the luciferase signal derived from IL-4 promoter was detected in the abdominal region, submandibular lymph node and mesenteric lymph node of the PA+EaEAC treated group, compared to PA+Vehicle treated group. Taken together, these results suggest that EaEAC treatment could successfully improve PA-induced skin inflammation of IL-4/Luc/CNS-1 Tg mice, and that IL-4 cytokine plays a key role in the therapeutic process of EaEAC.

Therapeutic effects of fermented soycrud on phenotypes of atopic dermatitis induced by phthalic anhydride / 한국실험동물학회지

Atopic dermatitis (AD), which is known as the most common pruritic skin disease, is caused by epidermal barrier dysfunction, allergies, microwave radiation, histamine intolerance, and genetic defects. To investigate the therapeutic effects of fermented soycrud (FSC) on AD pathology, alteration of AD phenotypes induced by phthalic anhydride (PA) treatment was assessed by ear thickness analysis, measurement of immune-related organ weights, ELISA, and histological and pathological analyses of ICR mice after FSC treatment for 2 weeks. Except for water content, the concentrations of most major components were lower in FSC compared to common tofu (CMT). Thymus and lymph node weights were significantly reduced in ICR mice treated with PA+CMT or PA+FSC, whereas spleen and body weights were maintained. Elevation of ear thickness induced by PA treatment was rapidly diminished in the CMT- and FSC-treated groups, although there was no significant difference between the two groups. Furthermore, significant reduction of epidermal thickness was detected in both the PA+CMT- and PA+FSC-treated groups. However, IgE concentration and dermal thickness were reduced only by PA+FSC treatment, whereas PA+CMT treatment maintained levels comparable to PA+vehicle treatment. The number of infiltrated mast cells was higher in the PA+vehicle-treated group compared to the untreated control. Following CMT or FSC treatment, mast cell infiltration was slightly reduced, although the CMT-treated group showed greater cell numbers. These results indicate that FSC may significantly relieve the phenotypes of AD induced by PA treatment and should be considered as a potential candidate for AD therapy.

In vitro and in vivo study of effects of fermented soybean product (chungkookjang) on NGF secretion ability and NGF receptor signaling pathway / 한국실험동물학회지

In order to investigate the effects of a fermented soybean product (Chungkookjang, CKJ) on nerve growth factor (NGF) metabolism, NGF secretion ability and its related signaling pathway were analyzed in B35 neuronal cells and the Tg2576 mouse model of Alzheimer's disease (AD). In B35 cells, the concentration of NGF significantly increased upon treatment with Taegwang (TG)-CKJ and Shinhwa (SH)-CKJ extracts compared with vehicle. Further, a significant increase in PC12 cell length as well as the phsophorylation levels of TrkA and Akt, which are members of a high affinity NGF receptor signaling pathway, were observed after treatment with TG-CKJ and SH-CKJ conditional medium (CM). On the other hand, there was no difference in activation of the NGF receptor p75NTR signaling pathway between vehicle and all CKJ treated groups. In Tg2576 mice showing early stage of AD, the concentrations of NGF in the serum and brain were reduced compared with those in Non-Tg mice. Treatment of Tg2576 mice with SH-CKJ, which contains high concentrations of total flavonoids and phenolic compounds, for 8 weeks dramatically recovered the NGF level to that of Non-Tg mice. Furthermore, the low phosphorylation levels of TrkA and Erk in the NGF receptor TrkA signaling pathway were rapidly recovered to those of Non-Tg mice after SH-CKJ treatment in vehicle treated Tg2576 mice, whereas the phosphorylation level of Akt was maintained at a constant level. These results suggest that CKJ may stimulate NGF secretion ability as well as the NGF receptor TrkA signaling pathway in PC12 cells and Tg2576 mice.

Clinical features of traumatic corneal endothelial rings

We report the clinical features and the course of traumatic corneal endothelial rings by trauma. Fourteen eyes (of fourteen patients) with traumatic endothelial rings (twelve cases of BB shot injury), were enrolled in this study. With median follow-up interval of 50 weeks, initial and final best corrected visual acuity, presence of combined injuries such as gross hyphema, and time of disappearance of traumatic endothelial rings were recorded. And specular microscopic examination was performed. The duration of existence of traumatic endothelial rings was mean 4.6 days. On the specular microscopic examination, the count of corneal endothelial cells in the injured eye decreased by mean 16.8% (ranged from 1 to 56%) than that in the opposite unjnjured eye. The duration of existence of traumatic endothelial rings was 3.5 days in the group without combined angle recession and was 6.1 days in the group with combined angle recession. We suggest that the possibility of traumatic corneal endothelial rings and resultant endothelial cell loss and their clinical potential should be always kept in mind in ocular trauma, particularly BB shot injury.

Axon Diameter in Normal Human Optic Nerve

PURPOSE: The morphometric change of optic nerve axons is one of the parameters for evaluating the optic nerve function in pathologic conditions such as optic neuritis, anterior optic neuropathy, glaucomatous optic nerve damage, and etc. There are various reports about the diameter of optic nerve axon and its change with age. This study was performed to observe the distribution and aging change of axon diameter, and morphometric characteristic of normal human optic nerve axon. METHODS: Eight enucleated eyes(36~80-year-old), which had no specific lesion in the optic nerve, were enrolled in the study. Optic nerve specimens at central and peripheral portions in each anterior and posterior sides of lamina cribrosa were obtained. The optic nerve axons were observed using transmission electron microscopy and the diameters of optic nerve axons were measured. RESULTS: The mean diameter of optic nerve axon was 1.172 micrometer(0.299 micrometer~6.432 micrometer, SD : 0.326). The mean diameter of optic nerve axon in anterior side of lamina cribrosa was 1.018 micrometer, central nerve fiber was 1.015 micrometer and peripheral nerve fiber was 1.022 micrometer. The mean diameter of optic nerve axon in posterior side of lamina cribrosa was 1.306 micrometer, central nerve fiber was 1.257 micrometer and peripheral nerve fiber was 1.355 micrometer. As age increased, the diameter of optic nerve axon had a tendency to increase(1.08 micrometer in 36-year-old, 1.373 micrometer in 80-year-old). CONCLUSIONS: The optic nerve axons in anterior side of lamina cribrosa were larger than those in posterior side of lamina cribrosa and the peripheral nerve fibers were larger than the central nerve fibers. This study demonstrated the morphometric variability of optic nerve fibers according to their locations and ages.

Histochemical Electron Microscopic Findings of Traumatic Cataract in Rabbits by Ruthenium Red

Glycosaminoglycans (GAGs)are essential components of the extracellular matrix of various tissues.They have been known to regulate cellular and extracellular environments for cell survival and differentiation in various physiologic and pathologic conditions.The present study was conducted to identify the distribution of GAGs in subepithelial cortical fibers of normal and traumatic cataractous lens of rabbits. Traumatic cataract was made by piercing the anterior lens capsule with 25-gauge sharp needle and the rabbits were killed at different time intervals (1, 2, 3 and 4 weeks).From the enucleated eyes subepithelial lens cortical fibers were obtained.A normal rabbit lens was used for the control. The specimens were stained with 0.05%ruthenium red (RR)and processed for histochemical electron microscopy. RR reactive materials were identified as fine granular or filamentous structures.In normal rabbit lens they were present mainly along the surface of lens epithelial cells, the surface of the subepithelial cortical fibers. In cataractous rabbits lens, strong RR positive reactions were observed along the surface of the lens epithelial cells and subepthelial cortical fibers as well as at the intercortical fiber spaces and even within its micro-organelles. This investigation resulted in an illustration of the ultrastructural distribution of GAGs in normal and traumatic cataractous lens of rabbit.this may suggest altered GAG distribution may closely related to the formation of lens opacity.

Ocular Dominance Determined by Near Point of Convergence Test in Intermittent Exotropia

This study was designed to validate the usefulness of the near point of convergence(NPC)test in determination of dominant & non-domnant eyes in intermittent exotropia patients. We performed NPC test in 36 intermittent exotrpic patients, and then, determined the non-dominant eye which deviated outward beyond the NPC. The dominant eyes determined by the NPC were compared to those that were determined by amblyopia, sensory fusion and photophobia. Best corrected visual acuity was used to divide patients into two groups : 26 patients without amblyopia, and 10 with amblyopia. Among the amblyopia group, if the eyes with better visual acuity were taken as dominant eyes, then eight(80%)cases were identical with the NPC test and two(20%)cases were different. Ten patients had sensory anomaly, and among then, nine(90%)cases were identical with the NPC test and one(10%)case was different. Twenty six(64%)patients had photophobia in one eye and all(100%)cases were identical with the NPC test. In intermittent exotropia, determination of dominant eye by the NPC test showed high coincidence with other tests. Therefore, we suggest that the NPC test is an easy and accurate method in determining either the dominant or non-dominant eye for surgery.

A Case of Ocular Torticollis Associated with Inferior Rectus Muscle Transection

A 31-years-old female presented with left eyelid, canalicular, and conjunctival lacerations after struck by a glass bottle.She had left hypertropia and limitation of depression.Primary repairs of left eyelid, canalicular, and conjunctival laceration were performed that day.After two weeks, the explorative operation was done because of the inability of depression of left eye. We identified the transection of inferior rectus muscle, and repaired it.Three months after second operation, there were 12 prism diopters of left hyper-tropia, 12 prism diopters of left exotropia in the primary position, and 20 prism diopters of left hypertropia in left down gaze.Double Maddox rod testing revealed 6degrees of left incyclotropia, and she presented head tilt to the left. Four months after second operation, 5 mm recession of left superior rectus muscle was done.Postoperatively, she had nearly orthotropia in primary position, but 10 prism diopters in left downgaze.She had only 2 degrees of left incyclotropia, and showed the improvement of ocular torticollis.

Distribution of the Glycosaminoglycans in the Bruch`s Membrane and Sensory Retina : Histochemical Electromic roscopic Findings with Ruthenium Red

The distribution of glycosaminoglycans in Bruch`s membrane and sensory retina of human eye was evaluated with histochemical electron microscope using 0.05%ruthenium red (RR). Seven donated or enucleated eyeballs without chorioretinal disease were used.Electron-dense RR reactive materials were identified as fine discrete granules along the basement membrane of the retinal pigment epithelium, in the inner and outer collagen layer and central elastic layer of Bruch 's membrane, and in the interphotorecep- tor matrix. In addition, they were observed at the cytoplasmic wall of photoreceptor cells, their intercellular spaces, and the internal limiting membrane. These results demonstrated that GAGs are widely distributed within the interphotoreceptor matrix, Bruch`s membrane, and intercellular spaces of retinal neurons. They are considered to function as a mechanical supporter as well as a selective filtration barrier through which the metabolitespass.

Glycogen Granules within the Co-cultured Conjunctival Epithelial Cells of Rabbit with Chlamydia Trachomatis

Inclusion bodies containing glycogen granules are characteristic feature of infected cells with Chlamydia trachomatis(C. trachomatis). In this study, we investigated the serial changes of the glycogen granules in a rabbit conjunctival epithelial cells co-cultivated with C. trachomatis.The epithelial cells isolated grom conjunctiva of rabbit were initially cultured for 3 weeks. After the cells had attained confluency, they were infected with C. trachomatis serotype D. After co-cultivation for 24, 48 and 96 hours, electronmicroscopic study was performed.After co-cultivation for 24 hours, a few glycogen granules were observed within the premature inclusion body containing some elementary bodies and reticulate bodies. After 48 hours of co-cultivation, typical inclusion bodies were observed and numerous electron-dense glycogen granules predominated around reticulate bodies. After 96 hours of co-cultivation, scattered glycogen granules were observed in granular pattern within the expanding inclusion occupying the bulk of the host cell cytoplasm.These results suggest that glycogen granules are closely related to the developmental cycle of the C. trachomatis and they may be an energy source for active multiplication of the reticulate bodies.

Oculocardiac Reflex During Strabismus Surgery

We perfomed this study to evaluate the incidence of the oculocardiac reflex(OCR) and its difference relative to each extraocular muscles. In addition, preventive methods for oculocardiac reflex were also evaluated. From Febrary 1997 to January 1998, we examined the occurrence of the OCR of 65 patients who underwent strabismus surgery in 123 extraocular muscles under the general anesthesia. Those who showed severe OCR were prepared with retrobulbar injection of 1% lidocaine 2cc or 1% intravenous atropine and observed wheather OCR was prevented. The overall incidence of the OCR was 66.2% and there was no significant difference between the incidence in both eyes(p>0.999). The incidence in each of the extraocular muscles did not show statistically significance when the patients were prepared with preoperative intramuscular atropine(p=0.018). The incidence after intraoperative retrobulbar injection or intravenous atropine was decreased to 27.3% but was not statistically significant(p=0.34).

An Efficacy of Head Tilt Test in the Patients with Unilateral Superior Oblique Palsy

Head tilt test is useful in diagnosing cyclovertical muscle palsy, especially superior oblique palsy, In this study, we observed efficacy and pattern of head tilt test in 12 patients of unilateral superior oblique palsy(7 congenital, 4 traumatic and 1 vascular) who had abnormal head tilt to nonparetic side. The results of head tilt test were compared to preoperative status in 8 patient, 3 month after surgery. All patients in this study showed positive response of head tilt test. Among them, 9 patients showed definite elevation of paretic eye. However, 2 patients mainly showed definite depression of nonparetic eyes that were amblyopic. The last patient did not show definite vertical deviation in either eye but complained of increasing diplopia. After surgery, abnormal head tilt and positive head tilt response disappeared in 7 patients. In conclusion, preoperative head tilt test is one of the valuable methods in diagnosisng unilateral superior oblique palsy especially in young patients and in those who developed spread of comitance. In addition, the positive head tilt test does no always mean the elevation of paretic eye.

A Case of Metastatic Uterine Cervical Carcinma of the Orbit

In adults, it is known that tetastatic tumor to the eye and its adnexa is rare compared with other sites. Orbital tumors can be classified as primary, secondary, and metastatic. Secondary orbital tumors are those that extend to the orbit from a contiguous structure. Metastatic tumors are those that spread to the orbit from more distant site in the body. and their prognosis for life is poor because of widespread systemic malignancy. We experienced a case of metastatic uterine cervical carcinoma of the orbit in a 33-year-old female patient who came to us with a history of sudden proptosis and decreased vision. Eighteen months earlier, the patient had been diagnosed with squamous cell carcinoma of the uterine cervix, and she had undergone chemotherapy, irradiation and surgical intervention. Lung and parametrium metastases were also found six months previously. We report a case of metastatic uterine cervical cancer of the orbit with a review of the literature.

A Case of Guillain-Barre Syndrome Presented as Bilateral Sixth Nerve Palsy

Guillain-Barre syndrome, acute inflammatory polyradiculoneuropathy, is sometimes accompanied by a typical ophthalmoplegia, usually with bilateral sixth nerve palsy. It also has a similar clinical appearance with Miller-Fisher syndrome, but it is differentiated by limb weakness without ataxia. We observed a 47 year old man with acute onset diplopia and bilateral sixth nerve palsy one week after URI symptoms, diagnosed as Guillain-Barre syndrome with ophthalmoplegia.

Detection of Eosinophil in Patient with Allergic Conjunctivitis by Impression Cytology

Allergic conjunctivitis is commonly encountered in the office parctice of ophthalmology. However, diagnosis is not easy because allergic conjunctivitis shows nonspecific ocular symptoms and signs. And for accurate diagnosis, conjunctival scraping for eosinophils, tear levels of specific IgE, skin testing to aeroallergens, and ocular challenge with allergens are available but these methods are much time and cost consuming. So we evaluate the usefulness of the detection of eosinophils by conjunctival impression cytology. Conjunctival impression cytology was done on 44 eyes of 44 patients who were diagnosed as allergic conjunctivitis. 7 eyes of 7 normal subjects and 14 eyes of 14 patients with epidemic keratoconjunctivits were used as control. Scoring system was defined according to the past history, symptom, sign, and slit lamp finding ranged from +1 to +5. Eyes of score +1 or +2 were defined as allergy suspect group, and eyes of score +3 to +5 defined as allergy group. The sensitivities of the impression dytology were 59% in allergy suspect group, 86% in definite allergy group and 72%in total, The specificity was 95%. According this study, we conclude that impression cytology is a simple, non-invasive and cheap method with high sensitivity and specificity for the diagnosis of allergic conjunctivitis.