Trends in recent waterborne and foodborne disease outbreaks in South Korea, 2015–2019

Objectives@#This study analyzed trends in foodborne and waterborne diseases in South Korea between 2015 and 2019. @*Methods@#The data consisted of information on outbreaks of waterborne and foodborne infectious diseases reported through the Korea Centers for Disease Control and Prevention(KCDC) system. We analyzed the trends and epidemiological aspects of outbreaks by month, place of occurrence, and causative pathogens in this observational study. @*Results@#The number of outbreaks has steadily increased over the last 5 years, but the number of cases per outbreak has followed a decreasing trend. Incidence at daycare centers and preschools has been steadily increasing over consecutive years. @*Conclusion@#The steady number of patients and decreasing number of cases per outbreak,even as the number of outbreaks has been increasing, suggest that the KCDC’s professional management system is operating effectively. It is necessary to continue improving the objectivity and efficiency of the management system and to carefully examine the increasing number of outbreaks in smaller-scale group catering facilities, such as daycare centers and preschools. Outbreaks can be prevented by closely examining those caused by unidentified pathogens and group outbreaks caused by other diseases, identifying problems, and supplementing the management system.

Trends in recent waterborne and foodborne disease outbreaks in South Korea, 2015–2019

Objectives@#This study analyzed trends in foodborne and waterborne diseases in South Korea between 2015 and 2019. @*Methods@#The data consisted of information on outbreaks of waterborne and foodborne infectious diseases reported through the Korea Centers for Disease Control and Prevention(KCDC) system. We analyzed the trends and epidemiological aspects of outbreaks by month, place of occurrence, and causative pathogens in this observational study. @*Results@#The number of outbreaks has steadily increased over the last 5 years, but the number of cases per outbreak has followed a decreasing trend. Incidence at daycare centers and preschools has been steadily increasing over consecutive years. @*Conclusion@#The steady number of patients and decreasing number of cases per outbreak,even as the number of outbreaks has been increasing, suggest that the KCDC’s professional management system is operating effectively. It is necessary to continue improving the objectivity and efficiency of the management system and to carefully examine the increasing number of outbreaks in smaller-scale group catering facilities, such as daycare centers and preschools. Outbreaks can be prevented by closely examining those caused by unidentified pathogens and group outbreaks caused by other diseases, identifying problems, and supplementing the management system.

Endocervical Adenocarcinoma In Situ Phenotype with Ovarian Metastasis

No abstract available.

An Intrarenal Adrenocortical Carcinoma Arising in an Adrenal Rest

We describe a case of a 61-year-old Korean man who was diagnosed with renal cell carcinoma that was discovered on abdominopelvic computed tomography obtained after the patient complained of back pain. A radical nephrectomy was performed, and the surgical specimen showed a relatively well-circumscribed and yellowish lobulated hard mass. Microscopically, the tumor showed sheets and nests of hypercellular pleomorphic cells with thick fibrous septation, frequent mitoses, and areas of adrenal cortical-like tissue. Immunohistochemical staining revealed that the tumor cells were positive for inhibin-α, vimentin, synaptophysin, and melan A. It also revealed that the tumor cells were negative for pan-cytokeratin, epithelial membrane antigen, paired box 8, α-methylacyl-coenzyme A racemase, CD10, cytokeratin 7, carbonic anhydrase 9, c-Kit, renal cell carcinoma, transcription factor E3, human melanoma black 45, desmin, smooth muscle actin, S-100, chromogranin A, CD34, anaplastic lymphoma kinase, and integrase interactor 1. Based on these histopathological and immunohistochemical findings, we diagnosed the tumor as intrarenal adrenocortical carcinoma arising in an adrenal rest. Several cases of intrarenal adrenocortical carcinoma have been reported, although they are very rare. Due to its poor prognosis and common recurrence or metastasis, clinicians and pathologists must be aware of this entity.

Gastric Mucosal Calcinosis / 대한소화기학회지

No abstract available.

Blockade of VEGFR-1 and VEGFR-2 Enhances Paclitaxel Sensitivity in Gastric Cancer Cells

PURPOSE: Hypoxia-inducible factor-1alpha (HIF-1alpha) increases transcription of the vascular endothelial growth factor (VEGF) gene. Inhibition of VEGF abolishes VEGF mediated induction of HIF-1alpha. Recent reports suggested that HIF-1alpha also mediated the induction of class III beta-tubulin (TUBB3) in hypoxia. TUBB3 confers resistance to taxanes. Inhibition of VEGF may decrease the expression of HIF-1alpha and TUBB3. This study was undertaken to investigate the roles of vascular endothelial growth factor receptor (VEGFR) in gastric cancer cell behavior and to identify methods to overcome paclitaxel resistance in vitro. MATERIALS AND METHODS: The protein expression levels of HIF-1alpha and TUBB3 were measured in human gastric cancer cell lines (AGS) under normoxic and hypoxic conditions. The relationship between TUBB3 and paclitaxel resistance was assessed with small interfering TUBB3 RNA. AGS cells were treated with anti-VEGFR-1, anti-VEGFR-2, placental growth factor (PlGF), bevacizuamb, and paclitaxel. RESULTS: Hypoxia induced paclitaxel resistance was decreased by knockdown of TUBB3. Induction of HIF-1alpha and TUBB3 in AGS is VEGFR-1 mediated and PlGF dependent. Hypoxia-dependent upregulation of HIF-1alpha and TUBB3 was reduced in response to paclitaxel treatment. Expressions of HIF-1alpha and TUBB3 were most decreased when AGS cells were treated with a combination of paclitaxel and anti-VEGFR-1. AGS cell cytotoxicity was most increased in response to paclitaxel, anti-VEGFR-1, and anti-VEGFR-2. CONCLUSION: We suggest that blockade of VEGFR-1 and VEGFR-2 enhances paclitaxel sensitivity in TUBB3-expressing gastric cancer cells.

Suppressive Effect of 19-nor-1alpha-25-Dihydroxyvitamin D2 on Gastric Cancer Cells and Peritoneal Metastasis Model

The active metabolite of vitamin D, 1,25-dihydroxyvitamin D3 (calcitriol), inhibits the growth of several types of human cancer cells in vitro, but its therapeutic use is limited because it causes hypercalcemia. Among its analogs, 19-nor-1,25-dihydroxyvitamin D2 (paricalcitol), has fewer calcemic effects and exhibits an activity equipotent to that of calcitriol. We assessed the antitumor and anti-inflammatory effects of paricalcitol in gastric cancer cells, and evaluated the potential role of vitamin D in the treatment of peritoneal metastatic gastric cancer. In this study, treatment with paricalcitol inhibited gastric cancer cell growth and induced cell cycle arrest. Paricalcitol also induced apoptosis and showed anti-inflammatory activity. Moreover, the growth of intraperitoneal metastases in vivo was reduced in mice treated with paricalcitol. 18F-FDG uptake was significantly lower in the paricalcitol group compared to control group (SUV; control group 13.2 +/- 5.3 vs paricalcitol group 4.5 +/- 3.0). Intraperitoneal tumor volume was significantly lower in paricalcitol treated mice (control group 353.2 +/- 22.9 mm3 vs paricalcitol group 252.0 +/- 8.4 mm3). These results suggest that the vitamin D analog, paricalcitol, has anticancer activity on gastric cancer cells by regulation of the cell cycle, apoptosis, and inflammation.

Induction of 90K-specific Cytotoxic T Lymphocytes for Colon Cancer Immunotherapy

BACKGROUND: Dendritic cell (DC)-based tumor vaccine is an attractive modality for the treatment of colon cancer because it has been recurred and produced few side effects in patients. Secretory glycoprotein 90K has been found at elevated level in various cancer tissues and sera. We investigated to establish a more effective DC vaccine for the treatment of colon cancer in which the levels of 90K are elevated. METHODS: We obtained the concentrated 90K from 293T cells stably expressing 90K. DCs were cultured from peripheral blood monocytes, and a DC vaccine pulsed with tumor lysate was compared with a DC vaccine pulsed with 90K. We measured the functional activity for CTLs by using IFN-gamma-enzyme linked immunoabsorbent spot (ELISPOT) assay. RESULTS: DCs pulsed with tumor lysate+90K exhibited the enhanced T cell stimulation, polarization of naive T cell toward Th1. The CTLs generated by DCs pulsed with 90K efficiently lysed HCT116 cells. The results indicate that 90K-speicifc-CTLs can recognize 90K proteins naturally presented by colon cancer cells. CONCLUSION: Our study suggests that 90K-specific CTLs generated by 90K-pulsed DCs could be useful effector cells for immunotherapy in colon cancer.

Anesthetic management of renal cell carcinoma that extended into the right atrium through the inferior vena cava: A case report

Renal cell carcinoma (RCC) rarely extends to the cardiac chambers, and the presence of an extension of tumor thrombus to the inferior vena cava or the right atrium has not been shown to determine the survival of patients with RCC.Although an aggressive surgical approach remains the primary treatment for RCC, the anesthetic management remains a difficult intraoperative challenge.We report here on a case of performing cavoatrial tumor thrombectomy and radical nephrectomy in a patient with RCC with an intracardiac extension, and we used cardiopulmonary bypass and intraoperative trans-esophageal echocardiography to assess and treat this tumor.

Prediction of Successful Repositioning of Horizontal Canal Benign Positional Vertigo in Gufoni's Maneuver: A Preliminary Study / 대한평형의학회지

BACKGROUND AND OBJECTIVES: Although several methods of repositioning maneuver have been introduced for the benign paroxysmal positional vertigo involving horizontal canal (HC-BPPV), no study has investigated the nystagmus pattern during the repositioning maneuver and its correlation with the repositioning results. Therefore, we evaluated the predictive value of the nystagmus for successful repositioning by studying the nystagmus pattern during the position of the Gufoni's maneuver. MATERIALS AND METHODS: Seventeen consecutive patients (age range=36~76 years, median age=64), with a diagnosis of HC-BPPV were recruited between July and August 2010. The Gufoni's maneuver for apogeotropic and geotropic nystagmus was performed. After 30 minutes, the treatment outcome was evaluated according to the nystagmus pattern at the individual stage of Gufoni's maneuver. Successful treatment was defined by the resolution of positional vertigo in geotropic HC-BPPV and nystagmus shifted from apogeotropic to geotropic in apogeotropic HC-BPPV. RESULTS: In the successfully treated patients, 4 of 6 patients had the contralesional nystagmus between 1st and 2nd position of Gufoni's maneuver. Ipsilesional nystagmus in 1st position of Gufoni's maneuver was observed in 1 patient with apogeotropic nystagmus. And the other 1 patient with Geotropic HC-BPPV showed no nystagmus in 2nd position after contralesional nystagmus in 1st position of Gufoni's maneuver. Unsuccessfully treated 11 patients had a conversion of nystagmus direction in 2nd position after 1st step. CONCLUSION: During the 2nd position of the Gufoni's maneuver, a nystagmus toward unaffected side predicts a successful repositioning, whereas reversed nystagmus is suggestive of poor response to repositioning.

Acute Sensorineural Hearing Loss with Simultaneous Ipsilateral Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo: Report of a Case and Review of the Literature / 대한평형의학회지

Benign paroxysmal positional vertigo (BPPV) originating from the posterior semicircular canal (pSCC) is a common vestibular disorder. Advanced age, head or ear trauma, other inner ear disorders, female sex and osteopenia/osteoporosis are known predisposing factors for pSCC BPPV. An association with simultaneous ipsilateral sudden deafness remains to be elucidated. We report a 62-year old woman with sudden deafness and simultaneous ipsilateral pSCC BPPV.

Periodic Alternating Nystagmus in Vestibulocochlear Disorder / 대한평형의학회지

Periodic alternating nystagmus (PAN) is characterized by horizontal nystagmus that reverses direction periodically. PAN can occur in both congenital and acquired conditions. We report a 58-year old man with peripheral vertigo and hearing impairment showing PAN in darkness.

Intermittent Interscalene Brachial Plexus Block vs. Continuous Intraarticular Infusion for the Management of Postoperative Pain after Shoulder Surgery

BACKGROUND: Severe postoperative pain is a well-known problem following shoulder surgery. This study evaluates the clinical efficacy of intermittent interscalene brachial plexus block (ISBPB) compared with that of continuous intraarticular infusion (IAPCA) for the management of postoperative pain after shoulder surgery. METHODS: Fifty seven patients, scheduled for shoulder surgery during general anesthesia, were randomly allocated to one of two groups. Group ISBPB (n = 19) received a preoperative interscalene brachial plexus block using 20 ml of 0.5% bupivacaine followed by insertion of a 20-gauge polyamide catheter. This catheter was connected to a patient-controlled analgesia pump set immediately after surgery to administer a bolus of 0.75% ropivacaine 15 ml at lockout time intervals 8 hours. Group IAPCA (n = 38) received patient- controlled analgesia with 0.2% ropivacaine 100 ml (basal rate 2 ml/hr, bolus 0.5 ml, lockout time 15 min). Both groups received intravascular patient-controlled analgesia with fentanyl 10? 15 microg/ml (basal rate 1 ml/hr, bolus 2 ml, lockout time 15 min). All patients were given pethidine 25 or 50 mg when visual analogue score (VAS) >40 mm. VAS, circulatory and respiratory stress parameter (heart rate, noninvasive blood pressure and respiratory rate) and consumption of pethidine were measured during 72 hours following surgery at intervals of 8 hours. RESULTS: The mean VAS scores in the ISBPB group were significantly lower than in the IAPCA group for 72 hr after surgery (P < 0.01). Pethidine consumption in the ISBPB group was significantly lower than in the IAPCA group (P < 0.01). CONCLUSIONS: We concluded that intermittent interscalene brachial plexus block is an effective method of postoperative analgesia after major shoulder surgery.

Association Between Carotid Artery Stiffness and Headache Following Cilostazol Use in Cerebral Infarction Patients

BACKGROUND: Cilostazol leads to inhibition of platelet aggregation and to vasodilatation. It is widely used for the secondary prevention of cerebral infarction. However, headache is a well-known adverse effect of cilostazol, and these headaches may be caused by the vasodilation of the cerebral artery. The goal of our study was to assess the frequency and severity of headaches following cilostazol treatment and to evaluate factors related to the development of these headaches. METHODS: Seventy patients with cerebral infarction were included in this study. We measured the carotid intima media thickness (IMT), the distensibility of the carotid artery (CAD), the brachial ankle index (ABI), and the brachial ankle pulse wave velocity (PWV) in order to quantify the degree of atherosclerosis and arterial stiffness. Patients were then given 100 mg of cilostazol in tablet form twice daily. For three days, we evaluated headache incidence and severity using a verbal rating scale (0-10). RESULTS: Twenty three (32.9%) patients reported headache during cilostazol medication and 7 patients had severe headache. Women were more likely to develop headaches than men (p=0.03). In addition, the mean IMT was lower in subjects with cilostazol-induced headache than in the headache-free subjects (0.8+/-0.1 vs 1.01+/-0.2 mm, p=0.001), while CAD was higher in these subjects (0.3+/-0.1 vs 0.25+/-0.1, p=0.03). There was no difference in PWV and ABI. CONCLUSIONS: Lower carotid IMT, increased CAD, and female gender may be associated with the development of cilostazol-induced headache in patients with cerebral inafarction, but not the systemic arterial stiffness.

Assessment of Fluid Space after Infusion of Hartmann's Solution and Hydroxethyl Starch Solutions during General Anesthesia / 대한마취과학회지

BACKGROUND: Distribution and elimination of crystalloid or colloid solutions during inhalational anesthesia have not been adequately investigated. Hemoglobin dilution and fluid kinetic model have been shown to reveal the distribution and elimination of various kinds of fluids. Therefore, we assessed fluid space changes after Hartmann's solution or hydroxyethyl starch solution (HES) infusion during desflurane anesthesia. METHODS: We infused 20 ml/kg of Hartmann's solution, 8.5 ml/kg of Hextend(R) and 8.5 ml/kg of Voluven(R) during 20 min, after anesthesia induction and before surgical incision, and measured the hemoglobin changes. We used mass balance equations and a fluid kinetic model to evaluate the changes of fluid space. In the fluid kinetic model, we used one volume model, which allows estimation of the size of the body fluid space expanded by the fluid (V) and the elimination rate constant (kr). RESULTS: The expanded plasma volume of three different fluids, calculated using mass balance equations, showed a similar degree of expansion during infusion, however, after finishing infusion, the dilution effect of Hartmann's solution decreased rapidly and lasted less than HES. Fluid kinetic model shows the mean size of V of 12.3 +/-5.9 L for Hartmann' solution, 5.2 +/- 1.6 L for Hextend, and 4.5 +/- 1.6 L for Voluven. Corresponding kr values were 263.0 +/- 161.8, 36.5 +/- 31.8, and 34.1 +/- 21.3 ml/min, respectively. CONCLUSIONS: The distribution volume of intravenous fluids analyzed by kinetic model showed that crystalloid fluid has a similar volume distribution compared to extracellular fluid and HES distributed to a volume larger than blood volume. Analysis and simulation of plasma volume expansion using this model provide a helpful tool for anesthesiologists planning fluid therapy.

A Case of Acute Renal Failure due to Rhabdomyolysis Induced by Convulsion

Rhabdomyolysis is a syndrome resulting from skeletal muscle injury with release of muscle cell contents into the plasma. It has been reported as a cause of acute renal failure(ARF), and often associated with alcohol abuse, muscle compression, infections, and generalized seizure. Rhabdomyolysis-induced ARF is rare in children. We experienced a case of rhabdomyolysis-induced ARF in a 12-year-old boy who presented with azotemia and oliguria secondary to convulsion. After the control of convulsion by antiepileptic drugs, the daily urine output gradually increased and systemic features recovered with appropriate hydration and alkalinization.

Detection of Micrometastasis in Draining Vein before & after Manipulation and Peritoneal Cavity in Colorectal Cancer by Reverse Transcriptase-Polymerase Chain Reactions for Cytokeratin 20 and Carcinoembryonic Antigen

PURPOSE: Micrometastasis is known as a significant predictor of prognosis in colorectal cancer patients. Recently, reverse transcriptase polymerase chain reaction (RT-PCR) has been applied to detecting micrometastasis. The drainage vein and peritoneum were examined and the micrometastases assessed in a series of colorectal cancer patients. METHODS: 22 patients, who were histologically diagnosed with colorectal cancer, and 8 patients of serosal and peritoneal brushing, were examined using RT-PCR to amplify the mRNAs for two epithelial markers, carcinoembryonic antigen (CEA) and cytokeratin 20 (CK-20). RESULTS: Among the 22 colorectal cancer patients, the positive rates of CK-20 and CEA mRNAs in the drainage vein were 10 (45%) and 7 (32%), and those of the serosal and peritoneal brushing were 6 (75%) and 5 (63%), respectively. CONCLUSION: These results suggest that the "no touch isolation technique" might be useful for operations in advanced colorectal cancer patients, and the brushing of the serosal or Douglas pouch can represent the micrometastasis status.

Use of RT-PCR for CK20 and CEA mRNA to Detect of Micrometastasis in the Draining Venous Blood and the Peritoneum in Gastric Cancer Patients

PURPOSE: The benefits of the "no-touch" isolation technique that is usually performed to prevent the circulation of tumor cells are not evident. The aim of this study was to determine whether the no-touch isolation technique for treating gastrointestinal cancers could prevent the circulation of tumor cells detected by reverse transcriptase polymerase chain reaction (RT-PCR). Matrials and Methods: By using RT-PCR to amplify mRNAs for two specific epithelial markers, carcinoembryonic antigen (CEA) and cytokeratin 20 (CK-20), we examined 34 gastric cancer patients who had been histologically diagnosed and 22 patients had undergone serosal and peritoneal brushing. RESULTS: In 10 (29.4%) of the 34 gastric cancer patients, we detected CK20 mRNA before manipulation, and in 17 (51.5%) of those patients, after we detected it. The density of the CK20 mRNA band was increased in 11 cases (33.3%) and the density was decreased in 2 cases (6.1%). In 16 (48.5%) of the 34 gastric cancer patients, we detected CEA mRNA before manipulation, and in 17 (51.5%) patients after we detected it. The density of the CEA mRNA band was increased in 8 cases (24.2%) and decreased in 3 cases (9.1%). CONCLUSION: These result suggest that the "no-touch isolation technique" might be useful when operating on advanced gastric cancer patients and that serosal or Douglas pouch brushing can be used to determine the status of micrometastasis.

Use of RT-PCR for CK20 and CEA mRNA to Detect of Micrometastasis in the Draining Venous Blood and the Peritoneum in Gastric Cancer Patients

PURPOSE: The benefits of the "no-touch" isolation technique that is usually performed to prevent the circulation of tumor cells are not evident. The aim of this study was to determine whether the no-touch isolation technique for treating gastrointestinal cancers could prevent the circulation of tumor cells detected by reverse transcriptase polymerase chain reaction (RT-PCR). Matrials and Methods: By using RT-PCR to amplify mRNAs for two specific epithelial markers, carcinoembryonic antigen (CEA) and cytokeratin 20 (CK-20), we examined 34 gastric cancer patients who had been histologically diagnosed and 22 patients had undergone serosal and peritoneal brushing. RESULTS: In 10 (29.4%) of the 34 gastric cancer patients, we detected CK20 mRNA before manipulation, and in 17 (51.5%) of those patients, after we detected it. The density of the CK20 mRNA band was increased in 11 cases (33.3%) and the density was decreased in 2 cases (6.1%). In 16 (48.5%) of the 34 gastric cancer patients, we detected CEA mRNA before manipulation, and in 17 (51.5%) patients after we detected it. The density of the CEA mRNA band was increased in 8 cases (24.2%) and decreased in 3 cases (9.1%). CONCLUSION: These result suggest that the "no-touch isolation technique" might be useful when operating on advanced gastric cancer patients and that serosal or Douglas pouch brushing can be used to determine the status of micrometastasis.

Telomere Length Changes in Colorectal Cancers and Polyps

Telomere Length Changes in Colorectal Cancers and Polyps Telomere shortening and telomerase activation occur frequently in cases of colorectal carcinoma. In this study, we correlated the clinicopathological parameters with the telomere length in colorectal carcinomas, colonic polyps, and normal colonic tissues. We also investigated whether the telomere length changes reflect the biologic behavior of tumors and different modes of tumor development. Telomere length was determined by terminal restriction fragment Southern blot analysis in 20 invasive colorectal carcinomas and normal mucosa from the same patients. We also examined 20 colonic polyps and associated normal mucosa. Telomere shortening was detected in 16/20 (80%), and telomere elongation in 2/20 (10%) cases of colorectal carcinoma, and no changes in 2 subjects. In the colonic polyp patients, shortening was detected in 4/20 (20%), elongation in 6/20 (30%), and no change in 10/20 (50%). The frequency of telomere shortening was significantly different between colorectal carcinoma and polyp groups. Decreased telomere length was noted in 92.9% (13/14) of Dukes' C and 50% (3/6) of Dukes' B. The difference between these two sub-groups was statistically significant. This study suggests that the telomere length in colorectal carcinomas is decreased upon the development of malignancy. A significant difference in telomere length between polyps and invasive colorectal carcinomas may reflect a different biologic behavior of colorectal carcinomas.