Intestinal Flukes Recovered from a Herring Gull, Larus argentatus, in the Republic of Korea

Trematode specimens were collected from the intestine of a herring gull, Larus argentatus, which was found in a critical condition on the shore of a small island (Yubu-do, Seocheon-gun, Chungcheongnam-do) located at the western coast of the Korean peninsula. Total 11 specimens of intestinal flukes, including 3 Cryptocotyle lingua (Heterophyidae), 1 Himasthla alincia (Echinostomatidae), 5 Cardiocephaloides medioconiger (Strigeidae), and 2 Diplostomum spathaceum (Diplostomidae), were recovered. C. lingua was morphologically characterized by the presence of a large ventrogenital apparatus and 2 obliquely tandem testes. H. alincia had an elongated body and a head collar equipped with 31 collar spines. C. medioconiger had a bisegmented body and a voluminous copulatory bursa containing the seminal vesicle and ejaculatory duct. D. spathaceum also had a bisegmented body and its vitellaria extended up to the anterior border of the tribocytic organ. It is of note that C. lingua is potentially zoonotic that can occur in birds and humans. Three of them, i.e., C. lingua, C. medioconiger, and D. spathaceum, are new trematode fauna in Korea. Studies on trematode fauna of migratory birds should be continued in Korea.

Infections of Soil-Transmitted Helminth in Refugees from North Korea

Soil-transmitted helminthiases (STH) are now no longer public health problems in the Republic of Korea (South Korea), but their status are unavailable in the residents of North Korea (NK) despite the expectation of large scale traffic and future reunification of the Korean Peninsula. A total of 20 female refugees from NK who had been admitted to the Division of Gastroenterology, Dankook University Hospital, were subjected in this study. Among them, 15 refugees were examined by the colonoscopy and 10 ones were examined with the stool examination (formalin-ether sedimentation). Both diagnostic methods were commonly adopted in 5 patients. Eggs of Trichuris trichiura were detected in 7 out of 10 refugees in the stool examination. In the colonoscopy, T. trichiura worms were found in 6 (40.0%) out of 15 refugees. Total 9 (45.0%) peoples were confirmed to be infected with human whipworms. Additionally, 1 case of clonorchiasis was diagnosed in the stool examination and a worm of Ascaris lumbricoides was discovered from a trichuriasis case. These findings suggested that STH is highly prevalent in NO, in which living conditions are not so good in the aspect of general hygiene and medical care.

Recovery of Oswaldotrema nacinovici from Whimbrels (Aves) in Korea

Adult specimens of Oswaldotrema nacinovici (Digenea: Philophthalmidae) have been first identified in Korea from 2 migratory birds (whimbrels, Numenius phaeopus) which were found dead at a western seashore area near Gunsan. The worms were recovered in the intestine of these birds. The worms were morphologically characterized by a large ventral sucker in comparison to the oral sucker, an external seminal vesicle extending beyond the posterior margin of the ventral sucker, and conspicuous uterine seminal receptacle. It was noteworthy that metacercariae-like bodies were contained within the inflated regions of 2 ceca. Other intestinal trematode species found in whimbrels included Spelotrema pygmeum, Gynaecotyla squatarolae, Maritrema obstipum, and Himasthla megacotyle. Zoonotic potential of these trematode species should be taken into considerations.

Massive pulmonary hemorrhage in enterovirus 71-infected hand, foot, and mouth disease / 소아과

Hand, foot, and mouth disease (HFMD) is an acute, mostly self-limiting infection. Patients usually recover without any sequelae. However, a few cases are life threatening, especially those caused by enterovirus 71 (EV71). A 12-month-old boy was admitted to a primary hospital with high fever and vesicular lesions of the mouth, hands, and feet. After 3 days, he experienced 3 seizure episodes and was referred to our hospital. On admission, he was conscious and his chest radiograph was normal. However, 6 hours later, he suddenly lost consciousness and had developed a massive pulmonary hemorrhage that continued until his death. He experienced several more intermittent seizures, and diffuse infiltration of both lung fields was observed on chest radiography. Intravenous immunoglobulin, dexamethasone, cefotaxime, leukocyte-depleted red blood cells, fresh frozen plasma, inotropics, vitamin K, and endotracheal epinephrine were administered. The patient died 9 hours after intubation, within 3 days from fever onset. EV71 subgenotype C4a was isolated retrospectively from serum and nasopharyngeal swab by real-time reverse transcription-polymerase chain reaction. Here, we report a fatal case of EV71-associated HFMD with sudden-onset massive pulmonary hemorrhage and suspected encephalitis.

Massive pulmonary hemorrhage in enterovirus 71-infected hand, foot, and mouth disease / 소아과

Hand, foot, and mouth disease (HFMD) is an acute, mostly self-limiting infection. Patients usually recover without any sequelae. However, a few cases are life threatening, especially those caused by enterovirus 71 (EV71). A 12-month-old boy was admitted to a primary hospital with high fever and vesicular lesions of the mouth, hands, and feet. After 3 days, he experienced 3 seizure episodes and was referred to our hospital. On admission, he was conscious and his chest radiograph was normal. However, 6 hours later, he suddenly lost consciousness and had developed a massive pulmonary hemorrhage that continued until his death. He experienced several more intermittent seizures, and diffuse infiltration of both lung fields was observed on chest radiography. Intravenous immunoglobulin, dexamethasone, cefotaxime, leukocyte-depleted red blood cells, fresh frozen plasma, inotropics, vitamin K, and endotracheal epinephrine were administered. The patient died 9 hours after intubation, within 3 days from fever onset. EV71 subgenotype C4a was isolated retrospectively from serum and nasopharyngeal swab by real-time reverse transcription-polymerase chain reaction. Here, we report a fatal case of EV71-associated HFMD with sudden-onset massive pulmonary hemorrhage and suspected encephalitis.

Recurred Sparganosis 1 Year after Surgical Removal of a Sparganum in a Korean Woman

Sparganosis, an infection due to the plerocercoid of Spirometra erinacei, are found worldwide but the majority of cases occur in East Asia including Korea. This report is on a recurred case of sparganosis in the subcutaneous tissue of the right lower leg 1 year after a surgical removal of a worm from a similar region. At admission, ultrasonography (USG) of the lesion strongly suggested sparganosis, and a worm was successfully removed which turned out to be a sparganum with scolex. Since sparganum has a variable life span, and may develop into a life-threatening severe case, a patient once diagnosed as sparganosis should be properly followed-up for a certain period of time. Although imaging modalities were useful for the diagnosis of sparganosis as seen in this case, serological test such as ELISA should also be accompanied so as to support the preoperative diagnosis.

Proper Application of Cyber Lecture on Neuroanatomy for Medical Students / 체질인류학회지

Recent development of cyber lecture system has greatly influenced on the medical education especially on anatomy related subjects. Furthermore, the technology associated to the cyber lecture system is now widely used as the evaluation tool for the medical students. The purposes of this study are to evaluate the opinions of students according to the types of cyber lectures which were applied to a basic medical subject (neuroanatomy) and to suggest practical services and applications available for the medical students. In this study, we adopted several teaching strategies such as online lecture system and web assisted instruction to the neuroanatomy class. Medical students of Dankook universitiy were classified into three groups (online lecture group, web assisted instruction group, and cyber lecture non-experienced group) and asked to complete anonymous survey in private. The majority of students had already experienced web-based leaning at least once. The degree of student satisfaction at the cyber lecture contents were relatively high in both online lecture group and web assisted instruction group. Students in all groups slightly preferred classical lecture room lecture but also seem to be familiar to the cyber lecture. Students from all groups suggested parallel progress with lecture room lecture as the proper application of cyber lecture. Growing demands of cyber lectures based on network technology is likely to make new paradigm of medical education in the near future. Practically, application of cyber lecture system to the lab course of sectional neuroanatomy and also to the preparation for the wide scoped examination might be suggested at this time.

Work-related Musculoskeletal Disorders in Korea Provoked by Workers' Collective Compensation Claims against Work Intensification

This article presents the process of workers' problems with work related musculoskeletal disorders (WMSDs), the introduction of risk assessments (RA) for their prevention, and the consequences of this process in Korea. In 1997, economic crisis caused a rapid increase of massive layoffs, worker dispatch system introduction, job insecurity, and use of irregular workers resulting in work intensification. Work intensification increased WMSDs, which created massive workers' compensation collective claims. Workers argued for the reduction of work intensity. The RAs introduced as a consequence of the workers' struggle is unique in the world. Whereas these RAs were expected to play a pivotal role in WMSDs prevention, they dis not due to workers' lack of engagement after the compensation struggle. In fact, changes in the compensation judgment system and criteria have resulted in lower compensation approval rates leading to lower workers' compensation claims. The Korean experience provides insight into WMSDs causes in a globalized world. In such a the globalized world, work intensification as the result of work flexibility could be an international trend.

Work-relatedness of lung cancer by smoking and histologic type in Korea

OBJECTIVES: This study investigated the distribution of causative agents related to occupational lung cancer, their relationships with work, and associations between work-relatedness and the histologic type of lung cancer. METHODS: We used data from the occupational surveillance system in Korea in 2013. In addition, data from 1,404 participants diagnosed with lung cancer were collected through interviews. We included the patients' longest-held job in the analysis. Work-relatedness was categorized as "definite," "probable," "possible," "suspicious," "none," or "undetermined." RESULTS: Among the subjects, 69.3% were men and 30.7% were women. Regarding smoking status, current smokers were the most prevalent (35.5%), followed by non-smokers (32.3%), ex-smokers (32.2%). Regarding the causative agents of lung cancer, asbestos (1.0%) and crystalline silica (0.9%) were the most common in definite work-related cases, while non-arsenical insecticide (2.8%) was the most common in probable cases followed by diesel engine exhaust (1.9%) and asbestos (1.0%). Regarding histologic type, adenocarcinoma was the most common (41.7%), followed by squamous cell carcinoma (21.2%). Among current smokers, squamous cell carcinoma was the most common among definite and probable cases (13.4%), while non-small cell lung cancer was the least common (7.1%). Among non-smokers, squamous cell carcinoma was the most common (21.4%), while the least common was adenocarcinoma (1.6%). CONCLUSIONS: Approximately, 9.5% of all lung cancer cases in Korea are occupational-related lung cancer. Well-known substances associated with lung cancer, such as crystalline silica, asbestos, and diesel engine exhaust, are of particular concern. However, the histologic types of lung cancer related to smoking were inconsistent with previous studies when work-relatedness was taken into account. Future studies are required to clarify the incidence of occupational lung cancer in agricultural workers exposed to non-arsenical insecticides and the associations between work-relatedness and the histologic type of lung cancer.

Underwater and Hyperbaric Medicine as a Branch of Occupational and Environmental Medicine

Exposure to the underwater environment for occupational or recreational purposes is increasing. As estimated, there are around 7 million divers active worldwide and 300,000 more divers in Korea. The underwater and hyperbaric environment presents a number of risks to the diver. Injuries from these hazards include barotrauma, decompression sickness, toxic effects of hyperbaric gases, drowning, hypothermia, and dangerous marine animals. For these reasons, primary care physicians should understand diving related injuries and assessment of fitness to dive. However, most Korean physicians are unfamiliar with underwater and hyperbaric medicine (UHM) in spite of scientific and practical values. From occupational and environmental medicine (OEM) specialist's perspective, we believe that UHM should be a branch of OEM because OEM is an area of medicine that deals with injuries caused by physical and biological hazards, clinical toxicology, occupational diseases, and assessment of fitness to work. To extend our knowledge about UHM, this article will review and update on UHM including barotrauma, decompression illness, toxicity of diving gases and fitness for diving.

Topography of Superficial Arteries on the Face / 체질인류학회지

The facial artery (FA) and superficial temporal artery (STA) from the external carotid artery and the supraorbital, supra- and infratrochlear arteries from the internal carotid artery are the superficial arteries distributing to the face. It was broadly known that the FA winds on the antegonial notch, ascends superomedially and finally reaches to the medial canthus area as forming the angular artery (AA). However many previous studies reported that the AA was only observed in 4~68% in their studies. The superior labial artery (SLA) from the FA issues the superficial and deep septal artery proceeding superiorly toward the nasal septum. It was reported that the nasal branches were ramified from the FA, after the bifurcation of the SLA in most Korean cadavers, and it seems that the lateral nasal and dorsal nasal arteries are crucial vasculature of the external nose. The branches of the ophthalmic artery distribute the glabellar and forehead, and they form anastomoses each other or are communicated to the AA. The topography of the superficial arteries of face is very important in the reconstructive surgery and non-invasive treatment such as the botulinum neurotoxin type A or dermal filler injection.

Intestinal Parasites among Wild Rodents in Northern Gangwon-do, Korea

To determine geographical patterns of natural parasite infections among wild rodents, a total of 46 wild rodents from 3 different localities in northern Gangwon-do (Province), Korea were examined for intestinal parasite infections. Along with nematodes such as hookworms and Syphacia spp., Plagiorchis muris (2 specimens) (Trematoda) were collected from striped field mice, Apodemus agrarius. In a Korean wood mouse, Apodemus peninsulae, the overall nematode infections were similar to A. agrarius, but an adult worm of Echinostoma hortense (Trematoda) was collected. In addition, 2 species of cestodes, i.e., Hymenolepis nana and Hymenolepis diminuta, were collected from A. agrarius. Through this survey, A. agrarius and A. peninsule were confirmed as the natural definite hosts for zoonotic intestinal helminths, i.e., P. muris, E. hortense, H. nana, and H. diminuta, in northern Gangwon-do, Korea. Considering increased leisure activities around these areas, seasonal and further comprehensive surveys on wild rodents seem to be needed to prevent zoonotic parasite infections.

Biocompatability of carbon nanotubes with stem cells to treat CNS injuries / 대한해부학회지

Cases reporting traumatic injuries to the brain and spinal cord are extended range of disorders that affect a large percentage of the world's population. But, there are only few effective treatments available for central nervous system (CNS) injuries because the CNS is refractory to axonal regeneration and relatively inaccessible to many pharmacological treatments. The use of stem cell therapy in regenerative medicine has been extensively examined to replace lost cells during CNS injuries. But, given the complexity of CNS injuries oxidative stress, toxic byproducts, which prevails in the microenvironment during the diseased condition, may limit the survival of the transplanted stem cells affecting tissue regeneration and even longevity. Carbon nanotubes (CNT) are a new class of nanomaterials, which have been shown to be promising in different areas of nanomedicine for the prevention, diagnosis and therapy of certain diseases, including CNS diseases. In particular, the use of CNTs as substrates/scaffolds for supporting the stem cell differentiation has been an area of active research. Single-walled and multi-walled CNT's have been increasingly used as scaffolds for neuronal growth and more recently for neural stem cell growth and differentiation. This review summarizes recent research on the application of CNT-based materials to direct the differentiation of progenitor and stem cells toward specific neurons and to enhance axon regeneration and synaptogenesis for the effective treatment of CNS injuries. Nonetheless, accumulating data support the use of CNTs as a biocompatible and permissive substrate/scaffold for neural cells and such application holds great potential in neurological research.

Differential expression levels of synaptophysin through developmental stages in hippocampal region of mouse brain / 대한해부학회지

The formation of neural synapses according to the development and growth of neurite were usually studied with various markers. Of these markers, synaptophysin is a kind of synaptic protein located in the synaptic vesicle of neuron or neuroendocrine cell known to be distributed consistently in all neural synapses. The purpose of this study was to investigate differential expression levels and patterns of synaptic marker (synaptophysin) in the mouse hippocampal region according to the developmental stages of embryonic, neonatal, and adulthood respectively. In the embryonic and neonatal groups, synaptophysin immunofluorescence was almost defined to cornu ammonis subfields (CA1 and CA3) of hippocampus and subiculum proper in the hippocampal region. However in dentate gyrus, synaptophysin immunoreactivities were insignificant or absent in all developmental stages. In embryonic and neonatal hippocampus, the intensities of immunofluorescence were significantly different between molecular and oriens layers. Furthermore, those intensities were decreased considerably in both layers of neonatal group compared to embryonic. The results from this study will contribute to characterizing synaptogenic activities in the central nervous system through developmental stages.

Differential expression levels of synaptophysin through developmental stages in hippocampal region of mouse brain / 대한해부학회지

The formation of neural synapses according to the development and growth of neurite were usually studied with various markers. Of these markers, synaptophysin is a kind of synaptic protein located in the synaptic vesicle of neuron or neuroendocrine cell known to be distributed consistently in all neural synapses. The purpose of this study was to investigate differential expression levels and patterns of synaptic marker (synaptophysin) in the mouse hippocampal region according to the developmental stages of embryonic, neonatal, and adulthood respectively. In the embryonic and neonatal groups, synaptophysin immunofluorescence was almost defined to cornu ammonis subfields (CA1 and CA3) of hippocampus and subiculum proper in the hippocampal region. However in dentate gyrus, synaptophysin immunoreactivities were insignificant or absent in all developmental stages. In embryonic and neonatal hippocampus, the intensities of immunofluorescence were significantly different between molecular and oriens layers. Furthermore, those intensities were decreased considerably in both layers of neonatal group compared to embryonic. The results from this study will contribute to characterizing synaptogenic activities in the central nervous system through developmental stages.

Differential Expressions of Synaptogenic Markers between Primary Cultured Cortical and Hippocampal Neurons

Primary dissociated neuronal cultures are widely used research tools to investigate of pathological mechanisms and to treat various central and peripheral nervous system problems including trauma and degenerative neuronal diseases. We introduced a protocol that utilizes hippocampal and cortical neurons from embryonic day 17 or 18 mice. We applied appropriate markers (GAP-43 and synaptophysin) to investigate whether neurite outgrowth and synaptogenesis can be distinguished at a particular period of time. GAP-43 was found along the neural processes in a typical granular pattern, and its expression increased proportionally as neurites lengthened during the early in vitro period. Unlike GAP-43, granular immunoreactive patterns of synaptophysin along the neurites were clearly found from day 2 in vitro with relatively high immunoreactive levels. Expression of synaptic markers from cortical neurons reached peak level earlier than that of hippocampal neurons, although neurite outgrowths of hippocampal neurons were faster than those of cortical neurons. The amount of peak synaptic markers expressed was also higher in cortical neurons than that in hippocampal neurons. These results strongly suggest the usefulness of primary cultured neurons from mice embryos for synaptic function and plasticity studies, because of their clear and typical patterns of morphology that establish synapses. Results from this study also suggest the proper amount of time in vitro according to neuronal types (cortical or hippocampal) when utilized in experiments related with synaptogenesis or synaptic activities.

Metric Skeletal Traits of the Excavated Bones from the Tombs of Paju Cultural Remains / 체질인류학회지

GyeongGi Provincial Museum and Korea Army Museum performed identification of Paju cultural remains. These areas were in particular situations because many kinds of mines still remained under the ground since Korean War. The identification and metric measurements were not easy because the excavated bones were destroyed partially and totally. Nine skeletons were excavated from the lime-soiled mixture tomb; six remains among nine were buried together in same grave and three remains were buried within wood coffins. Although many human skeletons were damaged and destroyed, period of the bones could be estimated at about late Chosun Dynasty with artifacts and epitaph that were found together. All the remains had been measured their full skeletal lengths before they were collected. The shortest and longest length of them reached 140 and 162 cm each with the average 152.6 cm but we could hardly estimate real heights of all remains with only these data. Each skeletons collected were classified into axial and appendicular skeletons and we obtained all the possible metric values of skull, mandible and sacrum from axial skeletons and clavicle, humerus, radius, ulna, pelvis, femur and tibia from appendigeal skeletons. In case of missing or severely damaged bones, we couldn't get metric data or could get only individual values. Although some demographic informations are still missing, these results will be used as a set of metric database for the systematic and detailed ancient physical anthropology studies.

Effect of Stimulation Intensity and Location of Cerebral Infarction on Motor Evoked Potentials in the Rat

OBJECTIVE: To investigate the change of motor evoked potential (MEP) in the cerebral infarction, and observe the effect of stimulation intensity and location of cerebral infarction, using rat model of cerebral ischemia induced by endothelin-1 (ET-1). METHOD: Middle cerebral artery (MCA) infarct, cortical infarct, and internal capsular infarct were induced in Spraugue-Dawley rats, by injecting ET-1 stereotaxically. MEP was recorded in forelimb by transcranial magnetic stimulation at 100%, 120%, and 150% of motor threshold by a small figure-8 coil. The location of cerebral infarction was confirmed histologically by 2,3,5-triphenyltetrazolium chloride (TTC) staining. RESULTS: In MCA infarct, MEP was not recorded at all intensity. In internal capsular infarct, no MEP was recorded at 100% of motor threshold, and amplitude was decreased at 120%. In cortical infarct, MEP was not recorded at 100%, but amplitude was maintained at 120% and 150%. Latency did not change significantly at all intensity. CONCLUSION: Amplitude of MEP decreased after cerebral infarction, but latency did not change. Decrease in amplitude was larger with deeper location of cerebral infarction. Cerebral cortex was stimulated at 100% of motor threshold, subcortical structure was stimulated at 120%, and deeper structure was stimulated at 150%, respectively.

Changes in Evoked Potentials in Focal Cerebral Cortical Ischemia in the Rat

OBJECTIVE: To investigate the changes of motor and somatosensory evoked potentials found in focal cerebral cortical ischemia induced by endothelin-1 (ET-1), one of the common models of cerebral infarct in rats. METHOD: A total of twenty Sprague-Dawley rats were studied. Focal cerebral cortical ischemia was induced by steterotaxic injection of ET-1 into forelimb region of cerebral cortex. Pellet retrieval test, motor evoked potential (MEP), and somatosensory evoked potential (SEP) were compared before and after cerebral ischemia. The location and extent of cerebral ischemia were confirmed histologically. RESULTS: Success rate of pellet retrieval test decreased significantly after induction of cerebral ischemia, demonstrating sensorimotor deficit in the contralateral forelimb. The latency and amplitude of MEP did not changed significantly despite weakness of forelimb. However, SEP showed reversal of the positive peaks. CONCLUSION: The results suggest that the changes of MEP and SEP in focal cerebral cortical ischemia are different from those in cerebral ischemia by large artery occlusion. When evaluating MEP and SEP in focal cerebral ischemia model, interpretation of evoked potentials should be cautious.

Expression and Distribution of BDNF (Brain Derived Neurotrophic Factor) in the Rat Hypothalamus / 대한해부학회지

BDNF belongs to the neurotrophin family and important molecular mediator of functional and structural plasticity. The highest levels of BDNF are found in the hippocampus and hypothalamus of the adult rat. Hypothalamus is important because of its high degree of plasticity, but little is known about distribution of BDNF in hypothalamic nuclei. Therefore, it is necessary to study distribution and expression pattern of BDNF in each hypothalamic nuclei to understand changes of BDNF through various neural damages including spinal cord injury. Through this experiment, we found specific BDNF expression pattern in some regions of hypothalamus and the results are as follows. 1) BDNF expressions were found in median eminence, arcuate nucleus, supraoptic nucleus, and periventricular nucleus of rat hypothalamus. 2) BDNF immunoreactive cells and nerve fibers were of various shapes and sizes. 3) Glial cells also express BDNF in certain hypothalamic nuclei. These results seem to be useful for future investigations of neurochemical changes in the hypothalamus induced by various neural trauma or degenerative changes