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Purpose: This study aimed to examine the effect of parental self-esteem on late school-aged children's media device addiction by mediating marital conflict and children's self-esteem. Methods: This study used data from the 11th (2018) Panel Study on Korean Children. The participants consisted of 1,082 family triads (fathers, mothers, and children). Data were collected using the Rosenberg Self-Esteem Scale, Marital Conflict Scale, and K-Internet Addiction Scale. The data were analyzed using structural equation modeling with SPSS/WIN 27.0 and Mplus 8.7. Results: The final model showed a good fit for the data. Children's media device addiction was directly related to mothers' self-esteem, mothers' marital conflict, and children's self-esteem. Fathers' self-esteem had a significant indirect effect on children's media device addiction by mediating both fathers' and mothers' marital conflict. In addition, mothers' self-esteem had a significant indirect effect on children's media device addiction by mediating mothers' marital conflict. Conclusion: The findings indicates that self-esteem and marital conflict for both fathers and mothers have a significant effect on children's media device addiction. It suggests that more attention might be given to fathers and mothers in developing interventions to prevent children's media device addiction. [ABSTRACT FROM AUTHOR]

Purpose: The study aimed to translate the Couple Satisfaction Index (CSI 32) into Korean, to evaluate the reliability and validity of CSI 32 and short-form (CSI 16, 4) in the Korean context, and to determine a cut-off score for Korean couples., Methods: Korean Versions of the Couple Satisfaction Index (K-CSI) 32 was translated, back-translated, and reviewed by five bilingual experts. Confirmatory factor analysis (CFA) was conducted with data from a sample of 218 couples (N = 436) to test construct validity. Validity and reliability were evaluated. The receiver's operating characteristics curve analysis was used to obtain the cut-off score., Results: The construct validities of K-CSI 32, 16, and 4 were verified using one-factor structures. The results of CFA showed a slightly better fit for K-CSI 16 and 4 than for K-CSI 32. Convergent validity was supported by significant positive correlations of K-CSI with Kansas Marital Satisfaction Scale, Dyadic Adjustment Scale, and Family Relationship Assessment Scale. Moreover, the significant differences in K-CSI between normal and depressive group demonstrated known-group validity. Cut-off scores of 105.5 on K-CSI 32, 50.25 on K-CSI 16, and 13.25 on K-CSI 4 were validated to identify distressed couple relationships., Conclusion: For clinical practice, the reliable and valid K-CSI 32 has the potential to measure changes in couple satisfaction after couple therapy or interventions. Applying K-CSI 32 may facilitate research on couple and family relationships in nursing and contribute to the discussion on the role of couple satisfaction in mental health., Competing Interests: The authors declared that no conflict of interest., (© 2022 Korean Society of Nursing Science.)

Purpose: The purpose of this study was to develop a suicide prevention nursing competency program for visiting nurses, and to examine the effect of this program on suicide prevention-related knowledge, attitudes, and behaviors., Methods: A total of 66 visiting nurses were recruited from 10 public health centers and divided equally into the experimental and control group. For the experimental group, the suicide prevention nursing competency program was provided twice a week for 120 minutes across 3 weeks. Participants were asked questions related to suicide prevention knowledge, attitudes, and behaviors at pre, post, and 1 month after the intervention. Data were analyzed using descriptive statistics, a t-test, repeated measure ANOVA, and Friedman test., Results: There were significant differences in knowledge and behaviors at the measured time periods, and significant differences in attitudes and behaviors between the two groups. There were also significant interactions between groups and times in attitudes and behaviors. These results suggest that the effects of the program were persistent until the 1-month follow-up., Conclusion: The developed suicide prevention nursing competency program is effective in evidence-based education for visiting nurses to increase suicide prevention-related knowledge, attitudes, and behaviors., Competing Interests: The authors declared no conflict of interest., (© 2020 Korean Society of Nursing Science.)

Intussusception is a rare disease in adults. A demonstrable etiology is found in approximately 85% of all cases, and approximately 40% of them are caused by malignant tumors. A 65-year-old patient visited the outpatient department with mild abdominal pain without other symptoms. The initial laboratory test and simple X-ray showed normal findings. CT revealed intussusception in the ileocecal area. The initial colonoscopic biopsy revealed atypical cells. Follow up colonoscopy showed spontaneous reduction of the intussusception. Diffuse large B-cell lymphoma was suspected in the second colonoscopic biopsy. An elective operation was performed. This case reports a case of a spontaneous reduction of adult intussusception with a brief review of literature.

Purpose: The purpose of the study was to develop and test a model for predicting problem gambling in speculative game users based on Blaszczynski and Nower's pathways model of problem and pathological gambling., Methods: The participants were 262 speculative game users recruited from seven speculative gambling places located in Seoul, Gangwon, and Gyeonggi, Korea. They completed a structured self-report questionnaire comprising measures of problem gambling, negative emotions, attentional impulsivity, motor impulsivity, non-planning impulsivity, gambler's fallacy, and gambling self-efficacy. Structural Equation Modeling was used to test the hypothesized model and to examine the direct and indirect effects on problem gambling in speculative game users using SPSS 22.0 and AMOS 20.0 programs., Results: The hypothetical research model provided a reasonable fit to the data. Negative emotions, motor impulsivity, gambler's fallacy, and gambling self-efficacy had direct effects on problem gambling in speculative game users, while indirect effects were reported for negative emotions, motor impulsivity, and gambler's fallacy. These predictors explained 75.2% problem gambling in speculative game users., Conclusion: The findings suggest that developing intervention programs to reduce negative emotions, motor impulsivity, and gambler's fallacy, and to increase gambling self-efficacy in speculative game users are needed to prevent their problem gambling., Competing Interests: The authors declared no conflict of interest., (© 2018 Korean Society of Nursing Science.)

Purpose: This study aimed to examine the effects of cognitive behavior therapy for insomnia (CBT-I) based on the mobile social networking service (SNS) on dysfunctional beliefs and attitudes about sleep, sleep quality, daytime sleepiness, depression, and quality of life among rotating-shift nurses in a hospital in Korea., Methods: A nonequivalent control group pre-post test design was used. The participants included 55 nurses with rotating three-shift work (25 in the experimental group and 30 in the control group). For the experimental group, CBT-I using mobile SNS was provided once a week for 60 minutes over six weeks. Data were analyzed using descriptive statistics, χ²-test, independent samples t-test, and Mann-whitney U test with the SPSS 21.0 program., Results: In the homogeneity test of the general characteristics and study variables, there were no significant differences between the two groups. Nurses in the experimental group had significantly lower scores on dysfunctional beliefs and attitudes regarding sleep and sleepiness than nurses in the control group. Nurses in the experimental group had significantly higher scores on sleep quality and quality of life than nurses in the control group., Conclusion: These findings indicate that using the mobile SNS-based CBT-I is feasible and has significant and positive treatment-related effects on rotating-shift nurses' irrational thoughts and beliefs in association with sleep, sleep quality, daytime sleepiness, and quality of life. These contribute to expanding our knowledge of rotating-shift nurses' sleep issues and their preferences for intervention., Competing Interests: The authors declared no conflict of interest., (© 2017 Korean Society of Nursing Science)

Transarterial chemoembolization (TACE) is one of the most effective therapies for unresectable hepatocelluar carcinoma or metastatic hypervascular tumors. Abscess occurring in the other organs beside the liver after TACE is a complication that often occurs, sometimes potentially fatal. We report a case of spinal epidural abscess occurred after liver abscess complicated by TACE in a patient with metastatic neuroendocrine tumors to the liver. A 67-year-old female underwent TACE first for the metastatic lesions to liver, with a history of pancreatoduodenectomy for the primary pancreatic neuroendocrine tumor. Four days after TACE, sudden high fever occurred, and liver abscess was found on abdominal CT. Two days later, back pain and radiating pain to the right leg occurred, and lumbar spine MRI showed spinal epidural abscess. After intravenous antibiotics for 8 weeks and partial laminectomy, the patient recovered and was discharged without complications.

Anomalous union of the pancreaticobiliary duct (AUPBD) is a congenital anomaly that is defined as a junction of the bile duct and pancreatic duct outside the duodenal wall. This anomaly results in a loss of normal sphincteric mechanisms at the pancreaticobiliary junction. As a result, regurgitation of pancreatic juice into the biliary system develops and causes choledochal cysts, choledocholithiasis, cholangitis, pancreatitis and malignancy of the biliary tract. Gallbladder cancer or common bile duct cancer associated with AUPBD and choledochal cysts have been frequently reported. But, intrahepatic cholangiocarcinoma associated with this condition has been only rarely reported. Here, we report a case of intrahepatic cholangiocarcinoma associated with AUPBD and choledochal cyst.

Background/aims: Acute hepatitis A (HAV) is markedly increasing recently on. Some patients with acute hepatitis A show severe clinical course. The seroprevalence rate of IgG anti-HAV has been changing with the regions and the times. Vaccination and seroconversion rate of HAV are not well known. In this study, we aimed to study the difference of seroprevalence rate of IgG anti-HAV according to various clinical factors and to know the vaccination rate and seroconversion rate below 10 years old in the central region of South Korea including Cheonan city., Methods: Seven hundred seventy two subjects were included in the study from January to September 2009. We analyzed seroprevalence rate of IgG anti-HAV according to sex, age, region, and other viral markers. We interviewed the history of vaccination(1st, 2nd) and analyzed seroconversion rate according to vaccination time below 10 years old., Results: The total seroprevalence rate of IgG anti-HAV was 65.3%. The seroprevalence rate of IgG anti-HAV rate in 2nd, 3rd, and 4th decade was very low (1.9%, 18.8%, 44.8%). The vaccination rate of children was about 50%. The seroconversion rate after 1st, and 2nd vaccination were 85%, 96%., Conclusions: Catch-up vaccination for teenagers and young adults is needed. Immunizing children with HAV vaccine as a routine schedule should be considered.

Endoscopic retrograde biliary drainage (ERBD) is useful for the palliative decompression of biliary obstruction. However, the complications of ERBD include cholangitis, hemorrhage, acute pancreatitis, obstruction of the stent, and duodenal perforation. Pressure necrosis on the duodenal mucosa by the stent may contribute to perforation. Although duodenal perforation following ERBD is very rare compared to other complications, it can result in a fatal outcome. Recent reports describe nonsurgical treatment for small gastrointestinal perforation with localized peritonitis and suggest that endoclipping may be appropriate in the management of a well selected group of patients with iatrogenic perforation. We describe a case of duodenal perforation secondary to ERBD that was successfully treated with approximating using endoclip and detachable snare.

Background/aims: It is difficult to clinically and endoscopically differentiate intestinal tuberculosis (ITB) and Crohns disease (CD). The aim of this study was to evaluate the usefulness of in vitro interferon-gamma (INF-gamma) assay for differential diagnosis between ITB and CD., Methods: Sixty patients for whom differential diagnosis between ITB and CD was difficult were enrolled between January 2007 and January 2009. The INF-gamma-producing T-cell response to early secreted antigenic target 6 and culture filtrate protein 10 were measured by T-SPOT.TB blood test in vitro. We evaluated the usefulness of T-SPOT.TB blood test by comparing its results with the final diagnosis., Results: Twenty and forty patients were revealed to be positive and negative in T-SPOT.TB blood test, respectively. Of the 20 patients found to be positive, 12 patients (60%) were finally diagnosed as ITB, 6 patients as CD, and 2 patients as Behcets enterocolitis. Of the 40 patients with negative results, 38 patients (95%) were diagnosed as CD; one as Behcets enterocolitis; one as nonspecific colitis; none as ITB. The sensitivity and specificity of T-SPOT.TB blood test for ITB were 100% and 83.3%, respectively. Positive and negative predictive values of T-SPOT.TB blood test for ITB were 60.0% and 100%, respectively., Conclusions: When differential diagnosis between ITB and CD is difficult, T-SPOT.TB blood test may be a helpful and rapid diagnostic tool to exclude ITB. Prospective large-scaled studies are required for further evaluation of the usefulness of T-SPOT.TB blood test for differential diagnosis between ITB and CD.

Background: Cytogenetic abnormalities are one of the most reliable prognostic factors in acute leukemia. Combination of conventional chromosome analysis (CCA) and FISH provides higher sensitivity in detecting these genetic abnormalities, and it is effective to apply several FISH probes as a profile test. The objective of this study was to investigate the utility of FISH profile analyses in the initial diagnosis of acute leukemia., Methods: Two hundred and forty one de novo acute leukemia patients diagnosed from January, 2002 to November, 2007 were included. For acute lymphoblastic leukemia profile test, FISH probes for BCR/ABL, TEL/AML1, MLL gene rearrangement and CDKN2A deletion were used. For acute myeloid leukemia profile test, probes for AML1/ETO, MLL and CBFbeta gene rearrangement were used. The results of CCA and FISH profile tests were collected, and the positive rates were compared., Results: ALL FISH profile tests revealed additional genetic aberrations not detected by chromosome analysis in 48.6% (67/138) of cases, including those with normal karyotypes or no mitotic cells (37%, 51/138). Among these 51 cases, TEL/AML1 abnormalities were detected in 44.3%, followed by the abnormal CDKN2A signal (24.6%) and hyperdiploidy (18.0%). AML FISH profile tests revealed additional genetic abnormalities in 7.8% (8/103) of cases., Conclusions: FISH analysis as a profile test detected additional genetic aberrations in a significant proportion of acute leukemia, and was effective especially in detecting cryptic translocations, submicroscopic deletions and complex karyotypes. Our study supports the need to incorporate FISH profile test at initial work up in acute leukemia.

Background/aims: We studied the prevalence of chronic hepatitis B, C and abnormality on liver function among the population in northwest area of Chungnam., Methods: We have reviewed 40,112 adults who had received medical examination at health promotion center in Dankook university hospital. We studied them retrospectively about HBsAg, HBsAb, anti-HCV, and liver function test (LFT)., Results: Among the study subjects, 22,936 men and 17,176 women were involved. The overall seroprevalence of HBsAg was 4.2%. The prevalence in men (4.5%) was higher than that of women (3.7%) (p<0.001). The seroprevalence of HBsAg in their age was 5.1% in the 5th decade, 4.2% in the 2nd decade, 4.1% in the 4th decade, and 4.1% in the 6th decade. The overall seroprevalence of HBsAb was 65.1%. The overall seroprevalence of anti-HCV was 0.7%. After we reexamined them with HCV RNA or RIBA (Recombinant Immunoblot Assay), the prevalence of chronic hepatitis C was 0.09%. The LFT abnormality in total subjects was 11.4%. The LFT abnormality of chronic hepatitis B and C subjects was 21.72% and 63.2%., Conclusions: The prevalence of chronic hepatitis B and C was lower than that of previous studies. The prevalence of chronic hepatitis B in the 2nd decade was still high.

Background/aims: Focal nodular hyperplasia (FNH) is mandatory to be differentiated from other hepatic tumorous conditions such as hepatocellular carcinoma and adenoma. The purpose of this study was to explore the clinical, radiological and pathological features of FNH cases reported in Korea., Methods: We have searched the journals from the web site "http://koreamed.org" using keywords "focal nodular hyperplasia" and "liver" - total of 38 cases of FNH, 37 cases from 17 published articles and one case from our experience confirmed histologically, were reviewed and analyzed., Results: Thirty eight cases were diagnosed between gestational age of 36 weeks and 67 years. Seventeen female patients (45%) had no history of taking oral contraceptives. Twenty cases (52.6%) experienced clinical symptoms such as abdominal pain and palpable mass. Computed tomography revealed contrast-enhancement in 34 nodules (85%) and typical central stellate scar in 9 (22.5%) of 40 nodules. Magnetic resonance imaging showed T1 weighted low signal in 18 (60%) and T2 weighted high signal in 22 (73.3%) of 30 nodules. Six (60%) of 10 cases showed hypervascular staining on hepatic angiography. Among 38 cases, 32 (84.2%) cases had single nodule and their mean size was 3.9 cm (0.5-16 cm). Pathologically, fibrous septa, proliferation of bile ductules and arterial wall thickening were seen in most cases., Conclusions: Of all the FNH cases reported in Korea, there were some differences in clinical aspects of sex ratio, accompanying clinical symptoms, and relationship with oral contraceptives, compared with previous reports. Further prospective studies are needed by means of nation-wide clinical survey and analysis.

Background/aims: Cyclooxygenase-2 (COX-2) inhibitors reportedly inhibit the growth of hepatocellular carcinoma (HCC) via caspase-dependent or caspase-independent apoptosis, which is due to COX-2 being associated with hepatocarcinogenesis. Survivin is highly expressed in most human cancers, but the mechanism regulating survivin expression remains unclear. We investigated the regulatory expression of survivin in selective-COX-2-inhibitor-induced growth inhibition of hepatoma cells., Methods: After treatment with NS-398 (a selective COX-2 inhibitor) at various concentrations (10, 50, 100, 150, and 200 micrometer), the growth inhibition of Hep3B hepatoma cells was assessed by an MTT cell-viability assay, DNA fragmentation gel analysis, and flow cytometry. The expression of survivin transcript was analyzed by reverse-transcription polymerase chain reactions., Results: NS-398 inhibited the growth of hepatoma cells by an amount dependent on the concentration and the time since treatment. Apoptotic DNA ladder and flow-cytometry shifting to the sub-G1 phase were revealed in NS-398-induced growth inhibition of hepatoma cells. NS-398 suppressed the expression of the survivin gene in a concentration- and time-dependent manner., Conclusions: Survivin was down-regulated in the growth inhibition of hepatoma cells induced by a selective COX-2 inhibitor, NS-398, in a concentration- and time-dependent manner. These results suggest the therapeutic inhibition of COX-2 via suppression of survivin in HCC.

Spontaneous intrahepatic bleeding is a rare condition. In the absence of trauma, intrahepatic hematoma may be due to underlying liver disease. We report a case of hepatocellular carcinoma in the patient who had huge intrahepatic hematoma without definite intrahepatic tumor at the time of initial presentation. A 54-year-old man was admitted to our hospital with a sudden onset of upper abdominal pain. Initial abdominal CT scan showed huge hematoma measuring more than 13 cm in diameter in the right lobe of the liver. However, there was no enhancing lesion in the liver. Laboratory data showed high alanine aminotransferase, alpha-fetoprotein and positive HBsAg. The MRI and angiography could not also depict any mass in the liver. The patient was treated with percutaneous drainage on the intrahepatic hematoma. The cytology from drainaged blood revealed no malignant cell. After hematoma decreased, follow-up CT scan depicted an enhancing tumor in the liver. He underwent right hepatic lobectomy and histopathological examination showed hepatocellular carcinoma.

Background/aims: Recent studies have shown good performance for the detection of sources of gastrointestinal bleeding using multi-detector row computed tomography (MDCT). However, there are limited reports about the role of MDCT for localization of acute lower gastrointestinal (GI) bleeding. The purpose of this study was to evaluate the role of MDCT for detection and localization of acute lower gastrointestinal bleeding., Methods: A total of 49 patients underwent MDCT examination for the evaluation of acute lower GI bleeding were investigated prospectively. Sensitivity, specificity, positive and negative predictive values of MDCT for the detection of acute lower GI bleeding were assessed. Colonoscopy, angiography, RBC scan or postoperative results were adopted as the reference standard., Results: Sensitivity, specificity, positive and negative predictive values of MDCT for the detection of acute lower GI bleeding were 72.7%, 80%, 93.9% and 25%, respectively. Eighteen patients experienced massive bleeding and 5 of them could not undergo the colonoscopic examination due to massive bleeding. MDCT detected the bleeding focuses in all of 5 patients., Conclusions: MDCT is useful for the localization of acute lower GI bleeding. The procedure is brief, less invasive, and relatively accurate diagnostic method. Moreover, positive finding will allow directed therapeutic procedure such as angiography.

Background/aims: Most cases of hepatitis B virus (HBV) are transmitted vertically in endemic areas of HBV. The positivity of serum HBeAg/HBV DNA in pregnant women is associated with vaccine failure. Recently, a national program for HBV vaccines free of charge in neonates born to HBsAg-positive pregnant women is being performed. The aim of this study was to investigate the positivity of serological markers of HBV in pregnant women in Jeju, which is an island separated from the Korean peninsula and a promising cohort to evaluate the effect of a prevention program of HBV infection. In addition, we investigated the geographic differences in the prevalence of HBV infection because it has been reported that the prevalence of HBV has been high in this area previously., Methods: Between January 2001 and December 2002, all women who gave delivery were studied retrospectively. Women between the ages of thirty and forty, who received health screening at the Asan Medical Center health promotion center in Seoul, were analyzed as controls., Results: During the study period, 1,030 pregnant women (30.8 +/- 4.3 years) and 7,270 controls (33.1 +/- 5.0 years) were enrolled. The positivity of HBsAg was high in Jeju compared with that of Seoul (6.4% vs. 4.9%) (P=0.036). The positivity of HBeAg/HBV DNA was 31.8% (21/66) in HBsAg-positive pregnant women. The positivity of anti-HBs was low in Jeju compared with that of Seoul (54.5% vs. 68.8%) (P<0.001)., Conclusions: The positivity of HBsAg was found to be high in pregnant women in Jeju. Intensive supervision for HBV infection in pregnant women should be given in this area.

To evaluate the immature eggs of Paragonimus westermani as a source of diagnostic antigen, about a million eggs which were excreted by 104 adult worms were collected; their saline extract (soluble egg antigen; PwSEA) was prepared. The specific IgG and IgM antibody levels were observed in experimental dog paragonimiasis by micro-ELISA, using PwSEA as well as whole worm extract of 12 week-old P. westermani (PwWWE). The protein composition of the PwSEA was observed by disc-PAGE. The results could be summarized as follows: Specific IgG antibody to PwSEA began to increase on 8 weeks after the experimental infection; it maintained its high level until the observation period of 13 weeks. The levels of IgM antibody to PwSEA, however, did not show any significant change. Specific IgG antibody to PwWWE began to increase earlier from 2 weeks after the infection and continued to increase until the observation period of 13 weeks. Its level was much higher than that to PwSEA. Specific IgM antibody to PwWWE increased temporarily during 2-8 weeks after the infection. By disc-PAGE, PwSEA showed 2 protein bands of very low motility. The bands of PwSEA corresponded to the first and second bands in the electrophoretic pattern of PwWWE of the 12 week-old worms. The above results indicated that the PwSEA induced antibody production in dog paragonimiasis but its antigenicity was weaker than PwWWE to be used as a diagnostic antigen.

To evaluate the status of intestinal protozoan infections in inhabitants of Gangweon-Do, Korea, a total of 1,310 stool specimens (male 669, female 641) was collected from 2 cities and 3 counties. They were examined routinely 1 time by the method of formalin-ether sedimentation technique. The results were as follows: 1. The positive rate for any kind of the intestinal protozoan cysts was 8.9 %. 2. A total of 6 kinds of the intestinal protozoan cysts were detected. The prevalence rate of each protozoa were; E. histolytica 0.8 %, E. coli 7.6 %, E. nana 1.4 %, I. butschlii 0.2 %, G. lamblia 0.5 % and C. mesnili 0.5 %. 3. Sogcho-city showed the highest positive rate as 15.2 %, Myeongju county was the next as 11.3 % and Weonju-city showed the lowest positive rate as low as 3.9 %. 4. By age, the highest positive rate was found in 20-29 age group(12.4 %). Female (9.5 %) showed a slight higher positive rate than male (8.4 %).

As epidemiological parameters of human paragonimiasis, the positive rates of intradermal test and the sputum/stool examination have long been employed in population surveys. However, both the specificity of the intradermal test and the sensitivity of sputum/stool examination have been gradually declined as the endemicity was lowered; thus the gap between above two parameters widened. In such context, the development of a new epidemiological parameter or tool which makes it possible to accurately discriminate the active paragonimiasis cases was necessary. In the present study, the detection rate of Paragonimus-specific IgG antibody by micro-ELISA was evaluated as an indicator of epidemiologic status of human paragonimiasis in a population. A total of 4,285 students and inhabitants living in Bukpyeong Myeon and Bukil Myeon, Haenam Gun, Jeonlanam Do was surveyed in October 1983 by intradermal test first. Out of them, 244 case (5.7 %) were found positively reacted to VBS antigen of P. wetermani. Out of 168 positive reactors, 7 cases (4.2 %) were egg positive either by two times of sputum examination or by one stool examination. That indicated that only 0.16 % of total surveyed were confirmed as active paragonimiasis by egg detection. When sera collected from 239 positive reactors of intradermal test were tested by micro-ELISA for their specific IgG antibody, 40 cases (16.7 %) were found to be positive. All of 7 eggs positive cases were again positive for specific IgG antibody. Among remaining 232 intradermal test positive cases, 33 cases were positive for IgG antibody. In contrast to those, none of 42 positive reactors to intradermal test for Clonorchis and of 128 intradermal test negative cases showed positive for Paragonimus- specific IgG antibody. The rate of specific IgG antibody as detected by micro-ELISA appeared to be increased with the wheal size of the intradermal test. When the wheal size was over 13 mm in diameter, about 50 % of them were positive for specific IgG antibody. Thirty-one specific antibody positive cases were clinically evaluated by laboratory examinations (repeated sputum examination, peripheral eosinophil count and chest roentgenogram) and by history taking. Out of them 24 cases were associated with one or more positive laboratory findings; thus considered as active paragonimiasis cases. Out of 7 lab. finding-free cases 3 revealed past history of typical paragonimiasis symptoms, suggesting that they were in chronic or in convalescent stages. The remaining 4 cases were considered as either mild or ectopic infection cases; the possibility of cross-reaction with other helminthiases could not be ruled out. From the above results, it was inferred that the detection of Paragonimus-specific IgG antibogy by micro-ELISA was very much helpful in detecting the active cases as well as in proper evaluation of the endemicity of human paragonimiasis in a population. The convenience of mass handling of sera in micro-ELISA was considered another superiority as an epidemiologic tool.

In order to obtain more specific antigenic preparation for the diagnosis of human paragonimasis, crude saline extract of whole worm (=PwWWE), secretory-excretory components (PwSEC) and secretion-excretion-free somatic extract (PwSM) of 12 week-old Paragonimus westermani were filtrated through Sephadex G-200 gel column. The adult Paragonimus worms were obtained from experimentally infected dogs. A total of 11 antigenic solutions was lyophilized or diluted to adjust protein content of 1 mg/ml. To evaluate the antigenicity of crude antigens and fractions, micro-ELISA was done with the sera from P. westermani infected cases, C. sinensis infected cases and non-infected control cases to detect Paragonimus specific IgG antibody. The results were as follows: When the PwWWE was filtrated through Sephadex G-200 gel, it was separated into three fractions; PwWWE Fr. 1, PwWWE Fr. 2 and PwWWE Fr. 3. The percentage of protein content was 28.0 %, 21.6 % and 50.4 % respectively. The PwSM was also separated into three fractions; PwSM Fr. 1, PwSM Fr. 2, PwSM Fr. 3 and their percentage of protein content was 41.3 %, 38.6 % and 20.1 %. However, the PwSEC showed different fractionation pattern; i.e. fraction 1 (=PwSEC Fr. 1) and 3 (PwSEC Fr. 3) without fraction 2. The percentage of protein content was 14.0 % in PwSEC Fr. 1 and 86.0 % in PwSEC Fr. 3. When the antigenicity of each Paragonimus crude antigen and fractionated antigen was evaluated for specific IgG antibody by micro-ELISA in 10 human paragonimiasis sera, PwSEC Fr. 1 was the most potent antigen showing the mean absorbance 1.98. The PwWWE Fr. 1, PwSEC, PwWWE were next to that; their mean absorbance were 1.72, 1.38 and 0.83, respectively. The antigenicity of fractions 2 and 3 was much weaker in binding specific IgG antibody. When the antigens were reacted in micro-ELISA with 10 human clonorchiasis sera, most antigens showed weak reactivity. Each fraction 1 of crude antigens reacted higher than other fractions or crude antigens; the mean absorbance was 0.17 in fraction 1, but in others the absorbances were about 0.06. With non-infected control sera, the result of micro-ELISA revealed almost same pattern with those of the clonorchiasis sera. From the above results, it became apparent that PwWWE Fr. 1, especially PwSEC Fr. 1 was the most potent antigen reacted with Paragonimus specifc IgG antibody.