Enterobius vermicularis Infection among Preschool Children: A 12-Year (2008-2019) Survey in Large Cities and Provinces of the Republic of Korea

A 12-year nationwide survey (2008-2019) was performed to investigate the prevalence of Enterobius vermicularis infection among preschool children in Seoul, 4 large cites (Busan, Incheon, Daegu, and Ulsan), and 9 provinces (grouped into 5 localities) in the Republic of Korea (=Korea). The survey was carried out once a year by 16 regional offices of the Korea Association of Health Promotion. The cello-tape perianal swab method (1 smear per child) was applied to detect eggs of E. vermicularis and other helminths. According to the results, the egg positive rate of E. vermicularis infection in 2008-2009 was 1.8-2.0%, but it decreased gradually to 0.6% in 2019 (P<0.05). The prevalence was significantly higher in boys (0.7-5.0%, mean 1.8%) than in girls (0.5-2.8%, mean 1.3%) (P<0.05). The 2 most southern localities, Jejudo (Province) and Jeolla-do (inclusive of Jeollabuk-do and Jeollanam-do) and a mid-western province, Gyeonggi-do, revealed higher prevalences, whereas Seoul and Gangwon-do showed lower prevalences. The results indicate that a low-grade prevalence of E. vermicularis infection (less than 4%) has been maintained for the recent 12 years among preschool children in Korea. Continuous monitoring of enterobiasis in the child age group is necessary in Korea.

Enterobius vermicularis Infection among Preschool Children: A 12-Year (2008-2019) Survey in Large Cities and Provinces of the Republic of Korea

A 12-year nationwide survey (2008-2019) was performed to investigate the prevalence of Enterobius vermicularis infection among preschool children in Seoul, 4 large cites (Busan, Incheon, Daegu, and Ulsan), and 9 provinces (grouped into 5 localities) in the Republic of Korea (=Korea). The survey was carried out once a year by 16 regional offices of the Korea Association of Health Promotion. The cello-tape perianal swab method (1 smear per child) was applied to detect eggs of E. vermicularis and other helminths. According to the results, the egg positive rate of E. vermicularis infection in 2008-2009 was 1.8-2.0%, but it decreased gradually to 0.6% in 2019 (P<0.05). The prevalence was significantly higher in boys (0.7-5.0%, mean 1.8%) than in girls (0.5-2.8%, mean 1.3%) (P<0.05). The 2 most southern localities, Jejudo (Province) and Jeolla-do (inclusive of Jeollabuk-do and Jeollanam-do) and a mid-western province, Gyeonggi-do, revealed higher prevalences, whereas Seoul and Gangwon-do showed lower prevalences. The results indicate that a low-grade prevalence of E. vermicularis infection (less than 4%) has been maintained for the recent 12 years among preschool children in Korea. Continuous monitoring of enterobiasis in the child age group is necessary in Korea.

A Case of Community-acquired Bacteremic Empyema Caused by Kocuria kristinae / 감염과화학요법

Kocuria kristinae, part of the normal flora of the skin and oral mucosa, is seldom reported as a human pathogen; infection is mostly associated with immunocompromised patients in healthcare facilities. Here, we describe the first case of bacteremic empyema caused by K. kristinae acquired from the community. K. kristinae was isolated from pleural effusion and two sets of peripheral blood samples drawn from two different sites. The empyema resolved after the insertion of a chest tube and intravenous administration of piperacillin-tazobactam and levofloxacin.

A Case of Community-acquired Bacteremic Empyema Caused by Kocuria kristinae / 감염과화학요법

Kocuria kristinae, part of the normal flora of the skin and oral mucosa, is seldom reported as a human pathogen; infection is mostly associated with immunocompromised patients in healthcare facilities. Here, we describe the first case of bacteremic empyema caused by K. kristinae acquired from the community. K. kristinae was isolated from pleural effusion and two sets of peripheral blood samples drawn from two different sites. The empyema resolved after the insertion of a chest tube and intravenous administration of piperacillin-tazobactam and levofloxacin.

Impact of body mass index on the prognosis of Korean women with endometrioid adenocarcinoma of the uterus: A cohort study

OBJECTIVE: To analyze how pretreatment body mass index relates to known endometrial cancer prognostic factors and how it impacts the disease-free survival and cause-specific survival of Korean women with endometrial cancer. METHODS: The patients were divided into the non-obese ( or =25 kg/m2) according to their pretreatment body mass index. The 25 kg/m2 body mass index cut-off was based on the World Health Organization criteria for Asian people. The two groups were compared in terms of their clinicopathological characteristics and survival outcomes. RESULTS: A total of 213 consecutive patients with endometrioid adenocarcinoma of the uterus met the eligibility criteria of this study and were included in the analysis. Of these patients, 105 patients had a body mass index less than 25 kg/m2 (non-obese group) and 108 patients had a body mass index equal to or more than 25 kg/m2 (obese group). The two groups did not differ in terms of age, menopause, parity, height, FIGO (International Federation of Obstetrics and Gynecology) stage, tumor grade, tumor size, myometrial invasion, lymphovascular space invasion, cytology, and lymph node metastasis. Body mass index was not a significant factor for disease-free and cause-specific survival in univariate analysis, and after adjusting for all prognostic factors that were significant in univariate analysis, it did not associate significantly with disease-free and cause-specific survival. CONCLUSION: In Korean women with endometrioid adenocarcinoma of the uterus, a high pretreatment body mass index did not associate with other prognostic factors and had little impact on the disease-free survival and cause-specific survival of these women.

Accurate Diagnosis with Chest CT for Bronchial Foreign Body Removal in Young Patient: Report of Three Cases and Review of the Literature / 대한이비인후과학회지

Foreign body aspiration (FBA) is a common accident and remains a serious problem in young children. Undiagnosed and retained FBA could be a life-threatening risk and causes serious complications especially for young children. To prevent complications, prompt diagnosis and removal of foreign body is mandatory. Chest computerized tomography (CT) has recently become a very useful noninvasive diagnostic modality for bronchial FBA. We present here three different patients with bronchial FBA, which had been diagnosed by chest CT and completely removed under ventilating bronchoscopy without complication. The authors reviewed the literature and discussed the usefulness of chest CT on bronchial FBA in children.

Variety of prenatally diagnosed congenital heart disease in 22q11.2 deletion syndrome

OBJECTIVE: To analyze the spectrum of prenatally diagnosed congenital heart disease in a Korean population with 22q11.2 deletion syndrome, and to provide guidelines for screening 22q11.2 deletion prenatally. METHODS: This retrospective study evaluated 1,137 consecutive fetuses that had prenatal genetic testing for 22q11.2 deletion because of suspected congenital heart disease between September 2002 and December 2012, at Asan Medical Center, Seoul, Korea. RESULTS: Main cardiovascular diseases in the 53 fetuses with confirmed 22q11.2 deletions were tetralogy of Fallot (n = 24, 45%), interrupted aortic arch (n = 10, 19%), ventricular septal defect (n = 5, 9%), double outlet right ventricle (n = 4, 8%), and coarctation of the aorta (n = 4, 8%). Other cardiac defects were rarely associated with 22q11.2 deletion. One fetus had persistent truncus arteriosus, one had aortic stenosis, and one had hypoplastic right heart syndrome. Two fetuses had normal intracardiac anatomy with an isolated right aortic arch, and one had an isolated bilateral superior vena cava. CONCLUSION: A variety of congenital heart diseases were seen during the prenatal period. Conotruncal cardiac defects except transposition of great arteries were strongly associated with 22q11.2 deletion. When such anomalies are diagnosed by fetal echocardiography, genetic testing for 22q11.2 deletion should be offered. Even if less frequent deletion-related cardiac defects are detected, other related anomalies, such as thymic hypoplasia or aplasia, should be evaluated to rule out a 22q11.2 deletion.

The Footplate Suture Technique for External Nasal Valve Surgery

BACKGROUND AND OBJECTIVES: To report the preliminary results of the footplate suture technique for narrowing the columellar base to improve nasal respiration and the cosmetic features of the nasal sill. MATERIALS AND METHODS: Patients with nasal obstruction who presented with external nasal valve obstruction were treated with the footplate suture technique. Data on the patient characteristics, operative procedures, and outcomes were gathered from medical records. RESULTS: Five patients were included in this study. The footplate suture technique was used in all patients, together with septoplasty, batten graft and inferior turbinoplasty to improve the nasal valve obstruction as needed. In each case, divergent footplate segments of the medial nasal alar crura were identified and tied to medialize and narrow the columellar base. All patients had satisfactory subjective nasal breathing and cosmetic results. CONCLUSIONS: The footplate suture technique is an adjunctive procedure that improves the nasal obstruction and nasal sill disfiguration caused by external nasal valve obstruction, especially due to the divergent footplate segments of the medial alar crura.

The Expression of AGO2 and DGCR8 in Idiopathic Sudden Sensorineural Hearing Loss

OBJECTIVES: The microRNAs have been implicated in the development and function of the inner ear, especially in contribution to hearing. However, the impact of idiopathic sudden sensorineural hearing loss (SSNHL) on expression of miRNA biogenesis-related components has not been established. To investigate the regulations of microRNA (miRNA) biogenesis-related components, argonaute 2 (AGO2) and DiGeorge syndrome critical region gene 8 (DGCR8) mRNA expression in SSNHL and to evaluate the value of clinical parameters on their expression. METHODS: Thirty-seven patients diagnosed with SSNHL and fifty-one healthy volunteers were included in this study. We measured mRNA expression levels of AGO2 and DGCR8 in whole blood cells but erythrocytes of patients with SSNHL and controls, using reverse transcription and real-time polymerase chain reaction analysis. RESULTS: The mRNA expression level of AGO2 is upregulated in SSNHL. The expression level of AGO2 was significantly correlated with that of DGCR8 in both patients with SSNHL and controls. Expression level of AGO2 in SSNHL was correlated with white blood cell counts. CONCLUSION: This study demonstrated for the first time that the AGO2 mRNA expression level was upregulated in SSNHL, suggesting its important role in pathobiology of SSNHL development.

The first successful live birth following preimplantation genetic diagnosis using PCR for type 1 citrullinemia

Type 1 citrullinemia (CTLN1) is an autosomal recessive inherited metabolic disorder caused by anargininosuccinicnate synthetase deficiency. The patient was a 38-year-old Korean woman who is a carrier for CTLN1 and her first baby was diagnosed with CTLN1. Preimplantation genetic diagnosis (PGD) for CTLN1 in day 3 embryos using polymerase chain reaction was performed for live birth of healthy baby who is no affected with CTLN1. One unaffected blastocyst was transferred. This resulted in a clinical pregnancy and the live birth of healthy male twin. They were confirmed to be unaffected with CTNL1 by post natal diagnosis. This is the first case report of the use of PGD for CTNL1.

Anesthetic considerations in patients with large obstructing vocal process granuloma / 대한마취과학회지

No abstract available.

Comparison of the Pentax AWS and the Glidescope with the Macintosh laryngoscope for tracheal intubation in patients with Mallampati classification I or II

BACKGROUND: The Pentax AWS and the Glidescope are new intubating devices.They were designed to provide a view of the glottis without alignment of the oral, pharyngeal and tracheal axis. The purpose of this study was to evaluate the effectiveness of the Pentax AWS and the Glidescope in comparison with the Macintosh laryngoscope, when performing tracheal intubation in patients with mallampati classification I or II. METHODS: Ninety patients presenting for surgery requiring tracheal intubation, and who were deemed easy for tracheal intubation of mallampati classification I or II were randomly assigned to undergo intubation using a Macintosh (Group M, n = 30), Pentax AWS (Group P, n = 30) or Glidescope (Group G, n = 30). Time to complete tracheal intubation and number of attempts until successful intubation were recorded. Noninvasive blood pressure and heart rate recorded before induction (PI), just before intubation (PT), 1 min and 5 min after intubation. Patients were assessed for postoperative sore throat at 6-12 h after surgery. RESULTS: Time to secure the airway with the Macintosh 13.0 (min 7, max 23.0) s was lesser than with the Pentax AWS 20.4 (8, 51.2) s and Glidescope 22.1 (10, 42.0) s. There were no significant differences in the rate of successful intubations and sore throat among the groups. There were significant increases in both mean arterial pressure and heart rate 1 min after intubation in all groups compare with PI. CONCLUSIONS: The Pentax AWS and the Glidescope had no specific advantage over the Macintosh laryngoscope for the patients with normal airway.

Clinical Characteristics and Causative Organisms of Community-acquired Necrotizing Fasciitis / 감염과화학요법

BACKGROUND: Necrotizing fasciitis (NF) is an infrequent but potentially lethal infection characterized by rapid progressive destruction of fascia and fat, concomitant systemic toxicity, and high fatality. In spite of the clinical significance of NF, only limited data is available regarding the clinical characteristics of patients with NF in Korea. MATERIALS AND METHODS: We retrospectively reviewed the medical records of patients who had been diagnosed as community-acquired NF in 9 centers of the Republic of Korea between January 2000 and November 2010. RESULTS: During the study period, a total of 103 patients had a community-acquired NF. Of sixty six cases with causative microorganisms identified, the majority (55, 83.3%) had monomicrobial infections. Whereas streptococci were the most common cause of NF in patients without underlying diseases (16/24, 66.7%), variable organisms, such as staphylococci, streptococci, Enterobacteriaceae, and non-fermentative Gram-negative bacilli were causative organisms of NF in patients with underlying diseases. The majority of patients with NF caused by Vibrio vulnificus or Aeromonas hydrophila (7/9, 77.8%) had liver cirrhosis or alcoholism. Surgery to counteract NF was performed in 60.2% of patients with NF (62/102), and mean time to surgery was 3 days. In-hospital mortality was observed in 21 of 99 patients with available data (21.2%). In multivariate analysis, the presence of solid tumors (adjusted OR [aOR]=63.88, 95% CI=2.58-1580.61, P=0.011), shock (aOR= 24.19, 95% CI=2.00-292.19, P=0.012), bacteremia (aOR=87.53, 95% CI=3.99-1921.46, P=0.005), and Gram-negative bacilli infections (aOR=437.11, 95% CI=4.67-40956.82, P=0.009) were associated with in-hospital mortality. CONCLUSIONS: Streptococci were predominant causative organisms of community-acquired NF in patients without underlying diseases. However, in patients with underlying diseases, variable organisms such as staphylococci, streptococci, Enterobacteriaceae, or non-fermentative Gram-negative bacilli were isolated. NF caused by V. vulnificus or A. hydrophila occurred frequently in patients with liver cirrhosis or alcoholism.

Clinical Characteristics and Organisms Causing Erysipelas and Cellulitis / 감염과화학요법

BACKGROUND: Although erysipelas and cellulitis are common soft tissue infectious diseases, there have been a few studies which investigate clinical characteristics and causative organisms in Korea. MATERIALS AND METHODS: We retrospectively reviewed the medical records of patients who had been diagnosed with erysipelas or cellulitis from ten general hospitals between January 2009 and February 2011. RESULTS: During the study period, a total of 144 patients with erysipelas and 735 with cellulitis were recruited. The mean age of erysipelas patients was 53.6 years, and that of cellulitis patients was 47.5 years. Diabetes mellitus was the most common underlying disease in both groups. The most common site of erysipelas was the face (80.6%) and that of cellulitis was the lower extremity (64.9%). Culture studies have been done in 31.9% (46/144) of patients with erysipelas, and 41.1% (302/735) with cellulites. Causative organisms were identified in 3 patients (2.1%) with erysipelas and 57 (7.8%) with cellulitis. Streptococcus pyogenes was isolated from two patients with erysipelas, and group G streptococcus from one. Staphylococcus aureus (44.0%) was the most common isolate in patients with cellulitis, followed by streptococci (27.1%), Enteobateriaceae (11.9%), and Vibrio species (6.8%). First-generation cephalosporin was the most commonly used antimicrobial agent in both groups. CONCLUSIONS: beta-hemolytic streptococcus and S. aureus were the most common causative organisms of patients with erysipelas and cellulitis.

Electrical stimulation of the epiradicular space using a catheter with a removable stylet

BACKGROUND: Electrical stimulation can be used to verify the location of epidural catheters. Although epiradicular localization of a catheter is important for patients with radiating pain in the lower extremities due to spinal stenosis or disc herniation, no prospective study results pertaining to the stimulation threshold within the epiradicular space have been reported. Therefore, we set out to investigate the threshold current for motor response in the epiradicular space by the use of a catheter containing a removable stylet. In addition, this study examines the reliability of such epiradicular stimulation. METHODS: In 105 patients undergoing a retrograde interlaminar ventral epidural injection, a lumbar epiradicular catheter was inserted. Loss of resistance was used to identify the epidural space. Afterward, the TheraCath was advanced into the epiradicular space and connected to a nerve stimulator. A nerve stimulator delivered progressively, increasing electrical current until an appropriate muscle contraction was observed. Contrast media was then injected and epiradicular dispersal was assessed. RESULTS: Epiradicular stimulation yielded a mean threshold of 0.56 +/- 0.50 mA (range: 0.06 to 2.84). When compared with epiradicular dispersal as a gold standard, the sensitivity, specificity, positive predictive value, and negative predictive value of epiradicular stimulation with the TheraCath were 90%, 56%, 96% and 33%, respectively. CONCLUSIONS: The threshold current of an insulated needle required to elicit a motor response in the epiradicular space was evaluated. We conclude that the epiradicular stimulation test is useful for confirming catheter placement. Nonetheless, further studies are required before implementing its routine use in clinical settings.

The change of anterior atlanto-dense interval in atlantoaxial instability patients: preoperative vs postoperative

BACKGROUND: Atlantoaxial subluxation (AAS) is a frequent manifestation of rheumatoid arthritis (RA). The instability of the cervical spine caused by AAS is potentially fatal condition under intubation for surgery. Anterior atlanto-dens interval (AADI) is a mirror of the risk for neural injury. We evaluated the change of AADI in atlantoaxial instability patients, before and after surgery. METHODS: The present study included 56 patients who underwent surgical procedures by AAS. Lateral radiographs were checked at preoperative, postoperative, 1 month later and 6 month later. AADI was measured using picture archiving communication system (PACS) system in each lateral radiograph. RESULTS: The value of AADI is 8.40 +/- 2.29 mm in preoperative period, 2.72 +/- 0.53 mm in postoperative, 2.68 +/- 0.53 mm in 1 month, and 2.70 +/- 0.51 mm in 6 months later. After cervical fusion, AADI immediately decreased 5.68 +/- 2.24 mm. There were significant decreased in postoperative, 1 month and 6 months, when compared with preoperative AADI. CONCLUSIONS: After the cervical fusion of AAS, the neurological and radiological stability was achieved by decrement of AADI. We concluded that the cervical fusion of AAS provide more safety during endotracheal intubation by decreased AADI.

A Case of Community-Acquired Acinetobacter Meningitis / 감염과화학요법

Acinetobacter baumannii infections have become significant pathogen in hospitalized patients, especially in the intensive care unit setting. Community-acquired Acinetobacter meningitis in adults is a very rare infection of the central nervous system. Most community-acquired Acinetobacter infections have been reported from countries with a tropical or subtropical climate. Acinetobacter infections mainly affect patients with some form of comorbidity and are also associated with heavy smoking and excess alcohol consumption. In our case, a 62-year-old male patient with DM, hypertension, and excess alcohol consumption developed meningitis. Bulging membrane and inflammation were observed in the right ear. A. baumannii meningitis was confirmed by blood, CSF, and ear discharge culture. The patient was treated effectively with meropenem for 21 days. After antibiotic treatment, follow-up cultures of CSF, blood, and ear discharge showed a negative result, and the CSF cell profile was normalized. However, the patient died of recurrent pneumonia on hospital day 45. We report on a case of community-acquired Acinetobacter meningitis in an adult in Korea.

Infectivity and Pathogenicity of Hepatitis A Virus during an Outbreak in a Communal Living Setting / 대한내과학회지

BACKGROUND/AIMS: Acute viral hepatitis A infection in adults is an emerging public health problem in Korea. The infectivity and pathogenicity of hepatitis A virus (HAV) among people living in close contact have not been studied previously. This study investigated the secondary attack rate and pathogenicity rate of HAV during an outbreak among auxiliary police in a communal living setting in Korea. METHODS: A total of 70 people in close contact with a hepatitis A patient (index case) were enrolled in the study, which included a thorough oral history, physical examination, and laboratory testing. The subjects were part of an auxiliary police unit living in a communal setting (HAV contact group). Serum antibody titers were measured in the contact group at two points during the study. Subjects in another auxiliary police unit without exposure to hepatitis A were examined as a control group (HAV non-contact group). The secondary attack rate and pathogenicity rate were calculated from the data. RESULTS: In the HAV non-contact group, none of the subjects had anti-HAV antibodies. In the HAV contact group, three subjects had both IgM and IgG anti-HAV antibodies, and two had only IgG anti-HAV antibodies. Two of three HAV-infected subjects were treated for hepatitis A. CONCLUSIONS: The secondary attack rate of HAV was 4.3~7.1% and the pathogenicity rate was 40~66.7% in the group of young adults.

Causes and clinical characteristics of syncope in combat and auxiliary police in Korea / 대한내과학회지

BACKGROUND/AIMS: The most common type of syncope in young adults is neurocardiogenic in origin, which is not related to organic problems and has a benign nature. Therefore, there have been few reports regarding syncope in young Korean adults. Here, we examined the causes of syncope and its clinical characteristics in young combat and auxiliary police in Korea. METHODS: We performed a retrospective study of the medical records of 193 combat and auxiliary police in Korea admitted to the National Police Hospital for syncope or presyncope between January 2004 and December 2007. RESULTS: The subjects' mean age was 21+/-1.2 years, and there were 2.8+/-2.9 episodes of syncope (mean+/-SEM). The first syncope occurred after enlistment in the police in 102 patients (52.8%). Basic diagnostic studies showed two cases of elevated creatine phosphokinase and one case of anemia to be related to syncope. Syncope-related traumatic injuries occurred in 38 patients (19.7%), and syncope was more prevalent in the summer. Head-up tilt test was performed in 175 of the 193 patients, and 123 showed a positive response. Other evaluations, including brain magnetic resonance imaging, electroencephalography, and echocardiography, were not helpful for diagnosis. Syncope was neurocardiogenic in origin in the majority of cases. Other causes of syncope were exhaustion (n=2), hyperventilation syndrome (n=2), Meniere's disease (n=1), anemia (n=1), and psychiatric problems (n=5). The causes of syncope could not be identified in 59 patients (30.5%). CONCLUSIONS: Neurocardiogenic syncope was the most common type in our study population. More than half of our patients experienced their first episode after enlisting with the police. Further studies in these groups are necessary.

Advanced Korean Industrial Safety and Health Policy with Risk Assessment

This article describes a systematic roadmap master plan for advanced industrial safety and health policy in Korea, with an emphasis on. Since Korean industries had first emergence of industrial safety and health policy in 1953, enormous efforts have been made on upgrading the relevant laws in order to reflect real situation of industrial work environment in accordance with rapid changes of Korean and global business over three decades. Nevertheless, current policy has major defects; too much techniques-based articles, diverged contents in less organization, combined enforcement and punishments and finally enforcing regulations full of commands and control. These deficiencies have make it difficult to accommodate changes of social, industrial and employment environment in customized fashion. The approach to the solution must be generic at the level of paradigm-shift rather than local modifications and enhancement. The basic idea is to establish a new system integrated with a risk assessment scheme, which encourages employers to apply to their work environment under comprehensive responsibility. The risk assessment scheme is designed to enable to inspect employers' compliances afterwards. A project comprises four yearly phases based on applying zones; initially designating and operating a specified risk zone, gradually expanding the special zones during a period of 3 years (2010-2012) and the final zone expanded to entire nation. In each phase, the intermediate version of the system is updated through a process of precise and unbiased validation in terms of its operability, feasibility and sustainability with building relevant infrastructures as needed.