A comparative analysis of canine Internal Medicine pancreatic lipase tests for diagnosing pancreatitis in dogs

Objective@#Many qualitative and quantitative commercial cPL tests have been developed and used in veterinary clinics. This study aimed to compare three different methodologies SNAP cPL, Spec cPL, and Vcheck cPL tests to assess the concordance of these assays. @*Methods@#Fifty serum samples were collected from 36 dogs with or without pancreatitis and subjected to SNAP cPL, Spec cPL, and Vcheck cPL tests. Agreement and correlation coefficients were calculated between the test results, and correlations were determined during the management of the patients. @*Results@#The results of the three cPL assays were strongly correlated in 47/50 serum samples (94%). Cohen’s kappa analysis between the Spec cPL and Vcheck cPL showed near perfect agreement (κ = 0.960, p < 0.001), SNAP cPL and Vcheck cPL (κ = 0.920, p < 0.001), and Spec cPL and SNAP cPL (κ = 0.880, p < 0.001). The correlation coefficients (r) between data from Spec cPL and Vcheck cPL tests was calculated by Spearman’s correlation test (r = 0.958, p < 0.001).Furthermore, the patterns of change in serum cPL concentrations determined using Spec cPL and Vcheck cPL were significantly consistent during the monitoring period in 11 patients. @*Conclusions@#and Relevance: Our data illustrated that Spec cPL and Vcheck cPL tests are compatible for clinical use in the diagnosis and monitoring of canine pancreatitis.

Treatment Strategies of Improving Quality of Care in Patients With Heart Failure

Heart failure (HF) is a global health problem closely related to morbidity and mortality. As the burden of HF increases, it is necessary to manage and treat this condition well. However, there are differences between real-world practice and guidelines for the optimal treatment for HF. Patient-related, healthcare provider-related, and health system-related factors contribute to poor adherence to optimal care. This review article aims to examine HF treatment patterns and treatment adherence in real-world practice, identify clinical gaps to suggest ways to improve the quality of care for HF and clinical outcomes for patients with HF. Although it is important to optimize treatment based on evidence-based guidelines to the greatest extent, it is known that there is still poor treatment adherence, and many patients do not receive guideline-directed medical therapy, especially at the early stages. To improve medication adherence, qualitative evaluation through performance measurement, as well as education of patients, caregivers and medical staff through a multidisciplinary approach are important.

Study on the consumption practices and Importance-Satisfaction Analysis of meal-kit selection attributes among adults in their 20s and 30s / 한국영양학회지

Purpose@#This study examined the meal-kit consumption practices of adults in their 20s and 30s and analyzed the properties that should be given priority for improvement among the selection attributes to improve the quality of meal-kits. @*Methods@#Statistical analyses were conducted using the SPSS program (ver. 28.0) for χ2-test, t-test, one-way analysis of variance, Duncan’s multiple range test, factor analysis, and Importance-Satisfaction Analysis (ISA). @*Results@#Of the 249 subjects surveyed, 85.5% had some experience of purchasing meal-kits, with significantly more females than males (p < 0.01), significantly more married people than single people (p < 0.05), significantly more employed people than unemployed people (p < 0.05). Meal-kits were purchased most frequently for meals (60.6%), from discount stores or supermarkets (44.6%), and priced between 10,000 won and 20,000 won per person (46.9%). The overall satisfaction with meal-kits was 4.1 out of 5.0 points. The frequency of purchases was Korean soup dishes (69.5%), Korean main dishes (47.4%), and Korean street snacks (46.9%). Factor analysis of the meal-kit selection attributes revealed, 4 factors: ‘quality of food,’ ‘packaging and diversity,’ ‘quality of meal-kit,’ and ‘convenience and price.’ Compared to single-person households, multi-person households placed significantly higher importance on the ‘quality of food,’ ‘packaging and diversity,’ and ‘quality of meal-kit.’ The factor, ‘packaging and diversity’ were significantly higher in the importance evaluation scores for females (p < 0.01), married people (p < 0.05), and people in their 30s (p < 0.05) among meal-kit consumers. According to the ISA results, a critical aspect that meal-kit manufacturers or sellers should strengthen is ‘price.’ @*Conclusion@#Meal-kit products will need to be developed for various purposes that offer high value for money that can satisfy the consumers’ needs to improve the satisfaction of meal-kit consumers.

Reference diameter and characteristics of the distal radial artery based on ultrasonographic assessment

Background/Aims@#While distal radial artery (DRA) access is increasingly being used for diagnostic coronary angiography, limited information is available regarding DRA size. We aimed to determine the DRA reference diameters of Korean patients and identify the predictors of DRA diameter < 2.3 mm. @*Methods@#The outer bilateral DRA diameters were assessed using a linear ultrasound probe in 1,162 consecutive patients who underwent transthoracic echocardiography. The DRA diameter was measured by the perpendicular angle in the dorsum of the hand, and the average values were compared by sex. DRA diameter < 2.3 mm was defined as unsuitable for routine diagnostic coronary angiography using a 5 Fr introducer sheath. @*Results@#The mean DRA diameters were 2.31 ± 0.43 mm (right) and 2.35 ± 0.45 mm (left). The DRA was smaller in women than men (right: 2.15 ± 0.38 mm vs. 2.43 ± 0.44 mm, p < 0.001; left: 2.18 ± 0.39 mm vs. 2.47 ± 0.45 mm, p < 0.001). The DRA diameter was approximately 20% smaller than the radial artery diameter. A total of 630 (54.2%) and 574 (49.4%) patients had DRA diameter < 2.3 mm in the right and left hands, respectively. Female sex, low body mass index (BMI), and low body surface area (BSA) were significant predictors of DRA diameter < 2.3 mm. @*Conclusions@#We provided reference DRA diameters for Korean patients. Approximately 50% of the studied patients had DRA diameter < 2.3 mm. Female sex, low BMI, and low BSA remained significant predictors of DRA diameter < 2.3 mm.

Anti-Diabetic Drugs in Cardiovascular Disease / 대한내과학회지

Diabetes is one of the important risk factors in cardiovascular disease associated with atherosclerosis, and cardiovascular disease is the leading cause of death in patients with diabetes mellitus. Recent randomized placebo-controlled cardiovascular outcome trials of all new antidiabetic drugs have linked SGLT-2 inhibitors and GLP1-agonists to not only increased cardiovascular stability but significant reduction of cardiovascular disease. These results have led to preferential selection of the most effective and beneficial antidiabetic drugs with the evidence of cardiovascular safety and efficacy. Herein, we address cardiovascular stability and the effectiveness of antidiabetic drugs, focusing on recently developed ones.

Anti-Diabetic Drugs in Cardiovascular Disease / 대한내과학회지

Diabetes is one of the important risk factors in cardiovascular disease associated with atherosclerosis, and cardiovascular disease is the leading cause of death in patients with diabetes mellitus. Recent randomized placebo-controlled cardiovascular outcome trials of all new antidiabetic drugs have linked SGLT-2 inhibitors and GLP1-agonists to not only increased cardiovascular stability but significant reduction of cardiovascular disease. These results have led to preferential selection of the most effective and beneficial antidiabetic drugs with the evidence of cardiovascular safety and efficacy. Herein, we address cardiovascular stability and the effectiveness of antidiabetic drugs, focusing on recently developed ones.

Cross-Correlation Analysis of the Incidence of Multidrug-Resistant Organisms with Hand Hygiene Compliance and Effectiveness of Alcohol-Gel Hand Hygiene Practice / 대한임상미생물학회지

Background@#Multidrug- resistant organisms (MDRO) are a serious concern in healthcareassociated infections. Hand hygiene (HH) is essential to prevent the spread of MDRO in the healthcare institutes. The aim of this study was to investigate the relationship between the incidence of MDRO and hand hygiene compliance and the experimental effectiveness of alcohol-gel hand hygiene practice. @*Methods@#From March 2016 to September 2018, we analyzed the cross-correlation between the incidence of MDRO and the HH compliance each month at Gyeongsang National University Changwon Hospital. We employed an experiment to observe the effect of alcohol gel hand hygiene practice on the reduction of organisms on the hand surface using the handagar plates. @*Results@#Among the MDRO, only vancomycin-resistant enterococci (VRE) showed a moderate correlation with the HH rate (r = 0.55). The hand-agar plate experiment showed a significant bacterial reduction for inadequate HH (mean 3.47 CFU) and optimal HH (mean, 0.84 CFU) than before HH (mean, 11.56 CFU) (n = 32, P = 0.006). @*Conclusion@#The incidence of VRE showed a moderate correlation with HH among MDRO in the longitudinal analysis. HH practice was more effective in preventing the spread of VRE compared with other MDRO in our institute. Optimal alcohol-gel HH practice can effectively remove bacteria on the hand surface.

Anticoccidial Effect of CS 32 Compounds Against Eimeria tenella Infection in Chickens

Coccidiosis-causing Eimeria species are transmitted in poultry via the oral-fecal route and can lead to hemorrhagic diarrhea and mortality. This results in enormous economic losses in the poultry industry. Furthermore, its resistance to some currently used antibiotics is increasing. This has prompted the development of new alternative drug therapies that address the issue of chemical-free meat production. Effective management of infectious diseases in veterinary practice includes the induction of protective and adaptive immunity by treatment with an alternative agent. In this study, we evaluated the anticoccidial effects of dietary supplementation of Chosun University (CS) 32 compounds (0.1% and 1.0%) against Eimeria tenella, which was isolated and purified from the supernatant of culture broth of Bacillus strain (KCTC18250P), as well as its effect on the growth rate and feed efficiency in chickens. Overall, we observed a decrease in lesion scores and oocyte output in CS 32 compounds-treated chickens. We concluded that 0.1% CS 32 compounds displayed anticoccidial effects against E. tenella infection.

Cross-Correlation Analysis of the Incidence of Multidrug-Resistant Organisms with Hand Hygiene Compliance and Effectiveness of Alcohol-Gel Hand Hygiene Practice / 대한임상미생물학회지

Background@#Multidrug- resistant organisms (MDRO) are a serious concern in healthcareassociated infections. Hand hygiene (HH) is essential to prevent the spread of MDRO in the healthcare institutes. The aim of this study was to investigate the relationship between the incidence of MDRO and hand hygiene compliance and the experimental effectiveness of alcohol-gel hand hygiene practice. @*Methods@#From March 2016 to September 2018, we analyzed the cross-correlation between the incidence of MDRO and the HH compliance each month at Gyeongsang National University Changwon Hospital. We employed an experiment to observe the effect of alcohol gel hand hygiene practice on the reduction of organisms on the hand surface using the handagar plates. @*Results@#Among the MDRO, only vancomycin-resistant enterococci (VRE) showed a moderate correlation with the HH rate (r = 0.55). The hand-agar plate experiment showed a significant bacterial reduction for inadequate HH (mean 3.47 CFU) and optimal HH (mean, 0.84 CFU) than before HH (mean, 11.56 CFU) (n = 32, P = 0.006). @*Conclusion@#The incidence of VRE showed a moderate correlation with HH among MDRO in the longitudinal analysis. HH practice was more effective in preventing the spread of VRE compared with other MDRO in our institute. Optimal alcohol-gel HH practice can effectively remove bacteria on the hand surface.

Efficacy of horse chestnut leaf extract ALH-L1005 as a matrix metalloproteinase inhibitor in ligature-induced periodontitis in canine model

Matrix metalloproteinases (MMPs) are the main proteinases associated with periodontal tissue destruction and remodeling. Therefore, inhibition of host-derived MMPs has a key role in the prevention and reduction of periodontitis progression. Horse chestnut (Aesculus hippocastanum L.) extracts have been used as treatments for inflammatory disease, traditionally. This study assessed the clinical effect as a MMP inhibitor of horse chestnut leaf extract ALH-L1005 on periodontitis. ALH-L1005 was obtained from horse chestnut leaf and its MMP inhibitory activities estimated. Periodontitis was induced in beagles assigned to 4 groups and medicated for 6 weeks: low dose test (LT; ALH-L1005, 100 mg/kg/day), high dose test (HT; ALH-L1005, 200 mg/kg/day), positive control (PC; doxycycline, 10 mg/kg/day), or negative control (NC; placebo). Before and after administration, clinical indices of the teeth and MMP quantity in gingival tissues using zymography were measured. Clinical conditions of the LT, HT, and PC groups were significantly improved after 6 weeks. In zymographic evaluations, gelatinolytic and caseinolytic activities were suppressed in LT, HT, and PC groups but not in the NC group. The results suggest that ALH-L1005 could be an effective agent for clinical prevention and treatment of periodontitis by inhibiting the gelatinase and collagenase activities, which can detach periodontal ligaments from alveolar bone.

A Reinforced Endotracheal Tube Completely Severed by a Patient Bite and Lodged in the Right Main Bronchus / 대한중환자의학회지

Reinforced endotracheal tubes (ETTs) are designed to resist kinking or compression. However, these have a potential risk of being obstructed or severed by a patient's bite. We report a case in which a reinforced ETT was severed by tube-bite while the patient was in the prone position during an intensive care unit stay. Bronchoscopic evaluation showed that the severed distal part of the tube had lodged in the patient's right main bronchus, and it had to be surgically removed. The patency of reinforced ETTs should be carefully monitored in patients intubated in the prone position.

A Reinforced Endotracheal Tube Completely Severed by a Patient Bite and Lodged in the Right Main Bronchus / 대한구급학회지

Reinforced endotracheal tubes (ETTs) are designed to resist kinking or compression. However, these have a potential risk of being obstructed or severed by a patient's bite. We report a case in which a reinforced ETT was severed by tube-bite while the patient was in the prone position during an intensive care unit stay. Bronchoscopic evaluation showed that the severed distal part of the tube had lodged in the patient's right main bronchus, and it had to be surgically removed. The patency of reinforced ETTs should be carefully monitored in patients intubated in the prone position.

Local anesthesia with monitored anesthesia care for patients undergoing thyroidectomy: a case series / 대한마취과학회지

Because the current trend favors minimally invasive surgery for thyroid disease, increasing interest has developed for thyroidectomy under local anesthesia with monitored anesthesia care (MAC). Here, we retrospectively reviewed 18 cases of thyroidectomy performed under local anesthesia with MAC in a single center. All of the procedures were performed by a single surgeon, using local lidocaine infiltration around the incisional site and propofol plus remifentanil target-controlled infusion. Sore throat (4/18), hypocalcemia (1/18), and transient voice color change (1/18) were observed, but the patients recovered during the follow-up period. No cases of postoperative nausea and vomiting, hematoma, wound problems, or vocal cord paralysis were observed. Local anesthesia with MAC provided satisfactory sedation in most patients without conversion to general anesthesia.

A Case of Acute Macular Neuroretinopathy after Non-ocular Trauma

PURPOSE: In the present study, an unusual case of traumatic retinopathy presenting as acute macular neuroretinopathy was reported. CASE SUMMARY: A 69-year-old male was involved in a car accident and experienced a left 5th rib fracture. There was no direct ocular trauma. However, after the accident he noticed paracentral scotoma and loss of vision in his left eye. At initial examination 4 days after the trauma, central visual acuity was hand motion and visual field test revealed central scotoma in the left eye. Spectral domain optical coherence tomography showed hyper-reflectivity of the outer nuclear layer and disruption of the ellipsoid zone. Fluorescein angiography did not show any leakage or vascular damage but near-infrared autofluorescence imaging showed a dark lesion in the macular area. Visual acuity was improved to 0.2 at 2 weeks after trauma and 0.6 at 6 months after trauma while mild ellipsoid zone defect and visual field defect persisted. CONCLUSIONS: Traumatic retinopathy presenting as acute macular neuroretinopathy is an uncommon disease causing paracentral scotomas after non-ocular trauma, and to the best of our knowledge, this is the first reported case in Korea.

Factors associated with suicide ideation among subway drivers in Korea

BACKGROUND: There were several suicide events of subway drivers in Korea. The aim of this study is to explore work-related factors associated with suicide ideation among subway drivers. METHODS: We analyzed data from 980 male subway drivers. A section of the Korean version of the Composite International Diagnostic Interview (K-CIDI 2.1) was administered by trained interviewers to judge whether a driver has suicide ideation and to diagnose psychiatric disorders. A questionnaire was also administered to collect data on sociodemographic characteristics, work environments, occupational stress, person under train (PUT) experience, and work-related problems. Occupational stress was examined by using the Korean Occupational Stress Scale (KOSS). Logistic regression was applied to evaluate the association between work-related factors and suicide ideation among subway drivers. RESULTS: Regarding work-related problems, conflict with passengers and sudden stops due to the emergency bell were significantly associated with suicide ideation. MDD, PTSD, and panic disorder were strongly associated with suicide ideation. In the analysis of occupational stress, insufficient job control (OR 2.34) and lack of reward (OR 2.52) were associated with suicide ideation even after being adjusted for psychiatric disorders and other work-related factors. CONCLUSIONS: Insufficient job control and lack of reward were associated with suicide ideation among subway drivers. Strategies for drivers to have autonomy while working and to achieve effort-reward balance should be implemented. Furthermore, drivers who have experienced negative work-related problems should be managed appropriately.

Identification of Enterococcus faecalis antigens specifically expressed in vivo

OBJECTIVES: Molecular mechanism of the pathogenicity of Enterococcus faecalis (E. faecalis), a suspected endodontic pathogen, has not yet been adequately elucidated due to limited information on its virulence factors. Here we report the identification of in vivo expressed antigens of E. faecalis by using a novel immunoscreening technique called change-mediated antigen technology (CMAT) and an experimental animal model of endodontic infection. MATERIALS AND METHODS: Among 4,500 E. coli recombinant clones screened, 19 positive clones reacted reproducibly with hyperimmune sera obtained from rabbits immunized with E. faecalis cells isolated from an experimental endodontic infection. DNA sequences from 16 of these in vivo-induced (IVI) genes were determined. RESULTS: Identified protein antigens of E. faecalis included enzymes involved in housekeeping functions, copper resistance protein, putative outer membrane proteins, and proteins of unknown function. CONCLUSIONS: In vivo expressed antigens of E. faecalis could be identified by using a novel immune-screening technique CMAT and an experimental animal model of endodontic infection. Detailed analysis of these IVI genes will lead to a better understanding of the molecular mechanisms involved in the endodontic infection of E. faecalis.

Evaluation of short-term ex vivo culture with air/liquid system of porcine cornea / 동물의과학연구지

Regarding therapies for treatment of corneal wounds, ex vivo corneal culture is the most effective for minimizing expensive animal studies. Eighteen porcine enucleated eyes were soaked in 0.2% povidone iodine solution for disinfection prior to cornea excision. Subsequently, corneas were excised from whole eyes and filled with an agar/medium mixture. Corneas were transferred into culture dishes, after which culture medium was added until the limbus was covered. Cultures were then placed onto a plate rocker to mimic blinking action, followed by incubation at 37degrees C and 5% CO2. Corneas were harvested on Days 0, 3, and 7 after incubation, and optical coherence tomography (OCT) was performed on Day 7. Two eyes from each group were fixed in 2% glutaraldehyde/4% paraformaldehyde for low vacuum scanning electron microscopy (LV-SEM), and four eyes from each group were fixed in 10% neutral-buffered formalin for histological analysis. OCT results showed that central corneal thickness significantly increased by Day 7 compared to Day 0 (P<0.05). Using LV-SEM, gaps between endothelial cells were detected on Day 7 of ex vivo culture. In the histological evaluation, four to five stratified squamous cell layers, wing cells, and basal cells in the epithelium as well as flat-shaped keratocytes in the stroma were found on Day 0. By Day 7, stratified squamous cells and basal cells had decreased in number, and slightly round-shaped keratocytes were observed; however, the number of keratocytes was similar to that on Day 0. In this short-term ex vivo culture, epithelium and endothelium were sensitive to culture, whereas stroma and keratocytes were well maintained. An additional deswelling method will be needed to obtain more successful results in porcine corneal ex vivo culture.

Effect of probiotic 379D as an alternative to antibiotics for feed supplementation in broiler chickens / 동물의과학연구지

Antibiotics have been used to prevent disease, promote growth rate, and improve feed efficiency. However, the use of antibiotics in livestock has been restricted worldwide due to problems such as bacterial resistance. Therefore, probiotics among alternatives to antibiotics have gained attention in the livestock feed industry these days. This study was conducted to investigate the effects of dietary supplementation with probiotic 379D on safety, growth rate, and feed efficiency. In this study, bacterial strain 379D was isolated from soil and identified as a Bacillus sp. according to 16S rRNA sequence analysis. In an in vitro test, in-gel activity assay and antimicrobial susceptibility test were conducted to evaluate 379D. In an in vivo study, 379D was administered at concentrations of 0.1% and 1% to broiler chickens for 28 days. The results of in-gel activity assay and antimicrobial susceptibility test showed that strain 379D had broad spectrum antimicrobial activity. Furthermore, no adverse 379D-related effects were observed in 0.1% and 1% groups. Feed efficiency was higher in the 379D-treated groups than in the control group. In conclusion, 379D is expected to be used as a safe alternative to antibiotics in a feed supplement and will improve feed efficiency in broiler chickens.

Effect of Bevacizumab and Ranibizumab on the Expression of eNOS in Trabecular Meshwork Cells

PURPOSE: To compare the effects of bevacizumab and ranibizumab on the expression of eNOS in cultured human trabecular meshwork cells (HTMC). METHODS: Primarily cultured HTMC were exposed to 0.5 mg/mL bevacizumab and ranibizumab using 1% serum-containing media for 30 minutes. Expression of eNOS mRNA was assessed with RT-PCR. Additionally, after exposure to 20 ng/mL of vascular endothelial growth factor (VEGF) and 0.5 mg/mL bevacizumab and ranibizumab, the production of nitric oxide was assessed with Griess assay. RESULTS: VEGF increased the production of nitric oxide in HTMC. Bevacizumab and ranibizumab decreased the expression of eNOS mRNA and production of nitric oxide (p 0.05). CONCLUSIONS: In HTMC, both bevacizumab and ranibizumab decreased the expression of eNOS mRNA with no significant difference observed between the two drugs.

The Effects of Topical Carbonic Anhydrase Inhibitors on Nitric Oxide Production in Trabecular Meshwork Cells

PURPOSE: To investigate and compare the effects of topical carbonic anhydrase inhibitors on the production and expression of nitric oxide in cultured human trabecular meshwork cells (HTMC). METHODS: Primarily cultured HTMC were exposed to 0, 10, and 100 microM dorzolamide and brinzolamide using serum-deprived media for 3 days. Production of nitric oxide was assessed with Griess assay. Expressions of eNOS mRNA were assessed with RT-PCR. RESULTS: Both dorzolamide and brinzolamide increased the production of nitric oxide eNOS activity (p < 0.05). Dorzolamide had a more potent effect than brinzolamide on the production of nitric oxide and the expression of eNOS mRNA. CONCLUSIONS: Topical carbonic anhydrase inhibitors increased the production of nitric oxide, which was accompanied by increased eNOS activity. Dorzolamide had a more potent effect than brinzolamide on the production of nitric oxide and expression of eNOS mRNA in HTMC. The increased production of nitric oxide by topical carbonic anhydrase inhibitors involves mechanisms other than carbonic anhydrase inhibition.