Epidemiology of Legionella and Climatic Variables in Seoul, Korea

Legionella species are abundant in the built environment and are increasingly recognized as a cause of Legionnaires' disease (LD). As the number of cases of Legionnaires' disease acquired by local communities in the Seoul metropolitan area in Korea has been increased, there was concern that changes in environmental factors could affect disease outbreaks. We described the association between climatic variables and occurrence of legionellosis in Korea and Legionella detection rate in Seoul area. A total of 418 cases of legionellosis were reported between 2014 and 2017. There was a seasonal peak in summer. LD continuously occurred from early spring to winter every year and rapidly increased in summer. In the regression analysis, the primary variables of interest- PM2.5 (µg/m³), NO₂ (ppb), and a number of the date of issue O₃ warning were not significant except for average temperature (R²=0.8075). The Legionella detection rate in Seoul, Korea showed a trend similar to precipitation (P=0.708, ANOVA). A relatively high proportion of Legionella detection rate was shown, especially cooling tower (17.7%) and public bath (19.3%). This finding is in line with current understanding of the ecological profile of this pathogen and supports the assertion that legionellosis occurs through contamination of water sources.

Relationship between flavonoids intake and metabolic syndrome in Korean women with polycystic ovary syndrome / 한국영양학회지

PURPOSE: The purpose of this study was to investigate the relationship between dietary flavonoids intake and metabolic syndrome (MetS) in Korean women with polycystic ovary syndrome (PCOS). METHODS: A total of 223 subjects (mean age; 27.3 +/- 4.2 yrs, range; 17-38 yrs) were divided into the MetS group (n = 27) and non-MetS group (n = 196). Dietary intake data were assessed by 24-hour recall method for two non-consecutive days and the average of the two days was used to estimate the usual dietary intake. Dietary habits were assessed using the Mini Dietary Assessment (MDA) score. We analyzed the intakes of six flavonoid classes (anthocyanidins, flavan-3-ols, flavanones, flavones, flavonols, and iso-flavones) using a flavonoids database. RESULTS: After adjustment for age, total energy intake, alcohol consumption, smok-ing, regular exercise, and oral contraceptive use, dietary flavonols intake was significantly lower in the MetS group (5.1 +/- 2.4 mg/d) than in the non-MetS group (8.9 +/- 2.8 mg/d) (p = 0.0472). Intakes of other flavonoids except for flavonols did not differ between the two groups. In MDA scores, significant differences were observed only for that related to daily con-sumption of fruit or fruit juice (p = 0.0180). A significant inverse relationship was observed between flavonols intake and the risk of MetS (4th vs. 1st quartile, OR = 0.11, 95% CI = 0.02-0.62, p for trend = 0.0131). CONCLUSION: These results sug-gest that higher intake of flavonols may be beneficial for MetS in PCOS women.

Qualitative Study on the Perception of an Unbalanced Diet from the Viewpoint of Elementary School Students

The purpose of this study was to investigate the perceptions of an unbalanced diet by elementary school students using a qualitative approach to nutrition counseling. To achieve the purpose of this study, client-centered counseling was performed over one semester with four volunteer children in the fifth grade who admitted eating an unbalanced diet. Their perceptions of an unbalanced diet were examined while focusing on cause. The contents of the counseling sessions were recorded and their eating habits observed. The proposed perceptions of the clients of an unbalanced diet were as follows: regarding the causes of an unbalanced diet, there may have been a certain negative event or memory related to food as well as an individual disease or history of disease; regarding the meaning of an unbalanced diet, the clients had two kinds of time concepts (formal one and informal one) and defined the meaning of an unbalanced diet as a matter of being able to eat proper amounts of food within an inter-meal time; and regarding the results of an unbalanced diet, they based their results on the approval of their parents and teachers. Feeding at school was used as the background of this study, which examined the meanings and results of an unbalanced diet, and there existed a correlation between the meanings and the results.

The expression of p57(kip2) in normal ovaries and ovarian tumors / 대한산부인과학회지

OBJECTIVES: The purpose of this study is to investigate the expression of CDK (Cyclin dependent kinase) inhibitor, p57(kip2) in human ovarian corpus luteum, benign and malignant ovarian tumors. METHODS: 46 women undergoing laparoscopic surgery or laparotomy for ovarian tumors were enrolled. Total 46 formalin-fixed, paraffin-embedded sections of corpus luteum, benign and malignant ovarian tumors were stained by immunohistochemistry for expression of p57(kip2). RESULTS: p57(kip2) was stained in theca cell of growing follicle but not induced in human corpus luteum. There was the expression of p57(kip2) in mature teratoma, immature teratoma and endometrioma but not in epithelial ovarian tumors. CONCLUSIONS: These results showed that p57(kip2) expression may be not important in luteinization of the ovary and seemed not to play a role in development of epithelial ovarian tumors. However, it may involve pathogenesis of mature teratoma, immature teratoma and endometrioma.

A case of abdominal pregnancy confirmed by laparoscopy / 대한산부인과학회지

Approximately 1% of ectopic pregnancies are abdominal pregnancies and these may cause life-threatening bleeding and complications. Because of it's high maternal mortality and morbidity, early diagnosis and prompt decision making is important. But the clinical manifestation and physical examination is not specific, so early diagnosis and management is difficult. Presented here is a case of primary abdominal pregnancy. A 31-year-old woman presented with lower abdominal pain at 8 weeks of gestation. Diagnostic transvaginal ultrasound revealed large amount of peritoneal fluid, no intrauterine sac, and mass on left adnexa. Laparoscopy was performed and abdominal pregnancy on the rectal serosa was confirmed. We experienced a case of abdominal pregnancy which treated with laparoscopy without complications and present it with a review of the literature.

Effectiveness of Sengstaken-Blankemore tube to control postpartum hemorrhage / 대한산부인과학회지

OBJECTIVE: To evaluate the effectiveness and identify the role of interventional procedure of tamponade treatment with modified Sengstaken-Blankemore (S-B) tube on control of postpartum hemorrhage (PPH) unresponsive to conventional medical treatment. METHODS: This study was performed retrospectively on the clinical records of 90 patients who had experienced PPH at the department of Obstetrics and Gynecology of OO University Hospital from February, 2000 to September, 2005. We have actively applied tamponade balloon since 2004. As a result, tamponade balloon were applied to 17 patients. Medical records were reviewed such as clinical status, cause of bleeding, volume of balloon, duration of balloon, complication, success rate and additional treatment. RESULTS: We have overall success rate of tamponade balloon in 11 (64.7%) of 17 patients of PPH. The causes of bleeding were subinvolution of uterus (100%), uterine atony (80%) and abnormal placentation (20%) in order of success rate. There was no major complication related to the tamponade procedure. We had compared final treatment during two period (before tamponade use v.s after tamponade use). 15 (33.3%) received invasive procedure and 8 (17.8%) received hysterectomy before tamponade use. However 10 (22.2%) received invasive procedure and just 1 (2.2%) received hysterectomy after tamponade use. CONCLUSION: Tamponade with modified S-B tube is effective on PPH unresponsive to conventional medical treatment and cuts down additional invasive procedure when tamponade treatment failed.

Comparison of Hospital stay and Cost-effectiveness between Treatment Modalities in Ectopic Pregnancy / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to compare the hospital stay and cost-effectiveness between treatment modalities in ectopic pregnancy for proper management. METHODS: In this study, the authors studied 121 cases retrospectively who had been admitted and treated at Department of Obstetrics and Gynecology, Konyang University Hospital from February 1, 2000 to August 31, 2003. We analyzed clinical features, treatment modality, hospital stay and cost-effectiveness between each groups. One-way ANOVA test was used and p<0.05 was regarded as statistically significant. RESULTS: There was no difference in clinical features between treatment modalites. Of total 121 cases, operative procedures were done in 105 cases (explo-laparotomy in 58, laparoscopy in 43, dilatation and curettage in 4) and medical treatment in 16 cases (Multiple dose methotrexate protocol in 11, Single dose methotrexate protocol in 5). Average of length of hospital stay was 5.3 +/- 0.2 days in explo-laparotomy, 3.8 +/- 0.2 days in laparoscopy, 2.8 +/- 1.4 days in dilatation and curettage, 6.5 +/- 0.5 days in multiple dose methotrexate protocol, 2.4 +/- 0.4 days in single dose methotrexate protocol. According to treatment modality, there was significant difference in total cost and cost sharing. Total cost in explo-laparotomy (875,324 +/- 25,977 Won) was more expensive than that of laparoscopy (734,375 +/- 35,179 Won). But, cost sharing in explo-laparotomy (156,543 +/- 9,583 Won) was less expensive than laparoscopy (319,493 +/- 26,255 Won). Total cost and cost sharing in multiple dose methotrexate protocol (323,231 +/- 33,972 Won, 184,465 +/- 17,344 Won) was more expensive than that of Single methotrexate protocol (192,495 +/- 31,180 Won, 68,793 +/- 13,422 Won). CONCLUSION: Based on these results, it is very important that we should have an interest in ectopic pregnancy for early detection and proper management. Consequently, Achievement of precise decision and successful methotrexate treatment can be possible to decrease hospital stay and cost-effectiveness.

Development of One-step Real-time Reverse Transcription-polymerase Chain Reaction in Combination with Automated RNA Extraction for Detection and Quantitation of Hepatitis A Virus

One-step real-time reverse transcription-polymerase chain reaction (RT-PCR) assay using the MagNA Pure LC and LightCycler(TM) system was developed and validated for the detection and quantitation of hepatitis A virus (HAV) RNA. The assay was evaluated using in-house synthetic HAV RNA standard. The real-time RT-PCR assay could quantitate a dynamic range of HAV RNA standard between 10(2) and 10(8) copies per reaction. The regression coefficient of the standard curve was an 0.99. The detection limit of the assay was 31.3 RNA copies per reaction. The coefficient variations (CVs) of the assay in combination with automated RNA extraction were less than 1.91% in both intra- and inter-assay. The real-time RT-PCR assay for quantitative detection of HAV would serve a useful method for improving the safety of biological products.

Evaluation of Limit of Detection and Range of Quantitation for RT-PCR, Real-Time RT-PCR and RT-PCR-ELISA Detection of Bovine Viral Diarrhoea Virus Contamination in Biologics Derived from Cell Cultures

Risk of viral contamination is one of major concerns common to all biologics derived from cultivated cells. Bovine viral diarrhoea virus (BVDV) has widely been known as a contaminant of cell culture-derived vaccines. The objective of the study was to assess the limit of detection and range of quantitation of the detection methods for BVDV using a reverse transcription-polymerase chain reaction (RT-PCR) assay, real-time RT-PCR assay, and RT-PCR-ELISA. One milliliter of cell culture supernatant containing 106.5+/-0.2 median tissue culture infectious dose (TCID50)/ml of BVDV NADL strain was subjected to RNA isolation. The isolated RNA was 10-fold serially diluted and each diluted sample (10-1 to 10-6) was subjected to RT-PCR on a GeneAmpR PCR System 9700 and/or LightCycler(TM). The amplified products were analyzedly (1) agarose gel electrophoresis for RT-PCR assay, (2) melting curve analysis for real-time RT-PCR assay (in this case a program is automatically linked to amplification step), and (3) ELISA using capture and detection probes for RT-PCR-ELISA. The limit of detection of the 3 assay methods was equally estimated to be 316 TCID50/ml of starting virus culture supernatant subjected to the assay. The quantitation range of real-time RT-PCR assay and RT-PCR-ELISA was estimated to be from 3.16x105 to 3.16x102 TCID50/ml of starting virus culture supernatant. The overall results suggested that the 3 assay methods for BVDV detection can be reliably applied to evaluate BVDV contamination in biologics derived from cell cultures.