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Two independent cases of oligochaete worms recovered from Korean women's vaginas are reported. Both specimens were non-parasitic cosmopolitan exotics identified as: microdrile tubificid Limnodrilus hoffmeisteri Claparède, 1862 (Tubificidae) and megadrile dichogastrid Dichogaster bolaui (Michaelsen, 1891) (Octochaetidae) - a new record for Korea. The tubificid is a freshwater euryhaline species that may reach high numbers in organically rich water e.g. in a paddy field, whereas the earthworm is commonly intercepted by quarantine in plant or vegetable cargos and also appears in bathtubs when it inhabits drainage systems. Thus, bathing/douching, field working or picnicking without a blanket are suggested as possible modes of ingress. Oligochaetes rarely occur in live human bodies but the few previous historical records are reviewed. [ABSTRACT FROM AUTHOR]

Background and Aim: Fluoroquinolone resistance of Helicobacter pylori is known to be dependent on mutations in the QRDR of gyrA. This study was performed to investigate the distribution of gyrA point mutations and to evaluate the impact of the mutations on second-line H. pylori eradication therapy. Methods: After H. pylori isolation from gastric mucosal specimens, fluoroquinolone resistance was examined using the agar dilution method. DNA sequencing of the QRDR of gyrA was performed in 89 fluoroquinoloneresistant and 27 fluoroquinolone-susceptible isolates. Transformation experiments were performed to confirm mutations in the resistant strains. The eradication rates of moxifloxacin-containing triple therapy were evaluated depending on the resistance of fluoroquinolone. Results: The gyrA mutations were detected in 75.3% (55 of 73 strains) of the primary resistant strains and 100% (16 strains) of the secondary resistant strains. The most common mutations were Asp-91 (36.0%) and Asn-87 (33.7%). The MIC values in the transformed strains differed depending on the gyrA mutations, N87, and D91. Six patients with fluoroquinoloneresistant strains received moxifloxacin-containing triple therapy as the second-line therapy, and two of three patients with Asn-87 mutations (66.7%) failed in the eradication. By contrast, three patients with Asp-91 mutations had successful eradication treatment. Conclusions: Fluoroquinolone resistance of H. pylori was caused by gyrA Asn-87 and Asp-91 point mutations. The Asn-87 mutation seems to be an important determinant of failure of fluoroquinolone-containing triple eradication therapy based on eradication results. [ABSTRACT FROM AUTHOR]

Background: Recent studies have shown that long working hours can have adverse consequences on health and possibly trigger biological processes that mediate the relationship between long working hours and cognitive decline., Objective: To investigate whether long working hours and the overall duration such exposure is associated with a decline in cognitive function., Methods: Data obtained during the Korean Longitudinal Study on Aging (n = 2,518) during the period 2006-2018 were used to explore the relationship between long working hours and cognitive decline. Korean version of the Mini-Mental State Examination (K-MMSE) scores were used to evaluate cognitive function. Cox proportional hazard regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs), which were used to evaluate declines in K-MMSE scores over the 12-year study period., Results: Overall HR (95% CI) for a decline in cognitive function in long working hours group was 1.13 (0.73-1.17). When categorized by sex, women with long working hours had an HR (95% CI) of 1.50 (1.05-2.22), K-MMSE scores decreased significantly after working long hours for 5 years (p < 0.01)., Conclusion: The study furthers understanding of the effects of long working hours on cognitive decline among female workers. Further research is required to determine the effects of long working hours on cognitive functions.

The present study measured 25 dimensions of the ear including the concha and ear canal for ergonomic design of ear products and compared with existing ear measurement studies. Scanning and casting methods were employed to produce 3D ear images for 230 Koreans and 96 Caucasians and measurements of the ear dimensions were obtained by identifying 21 landmarks on individual ear scan image. The Korean ear measurements were found significantly larger (mean difference d ¯  = 0.4-3.7 mm) and more varied (ratio of SDs =1.01-1.55) than those of Caucasians in most of ear dimensions. The average ear length and ear breadth of male were significantly longer ( d ¯  = 1.3-7.0 mm) and wider ( d ¯  = 0.8-3.0 mm) than those of female. Use of gender- and ethnicity-composite ear data is recommended in product design due to the much larger intra-population variations (7.5-22.2 mm) than the corresponding inter-population variations. Practitioner Summary: The 3D ear measurements of Koreans and Caucasians were collected and compared with those of different ethnic populations. The distinct ear features of the populations identified in this study are applicable to ergonomic design of ear products with better fit and comfort. Abbreviations: CCW: cavum concha width; CV: coefficient of variation; EB: ear breadth; EL: ear length; SD: standard deviation; SE: sampling error; 3D: 3 dimensional.

Introduction: Thiopurine drugs are metabolized via S-methylation and catalyzed by thiopurine S-methyltransferase (TPMT). Patients with very low TPMT activity are at high risk of fatal bone marrow toxicity when standard doses of thiopurine drugs are administered. TPMT genotyping can predict TPMT activity and is not affected by transfusion or red blood cell defects. Here, we report a new allele-specific real-time polymerase chain reaction (PCR) system for thiopurine methyltransferase genotyping that is validated in Korean population., Materials and Methods: Three major TPMT single-nucleotide polymorphisms (TPMT 2, 3B, and 3C) were genotyped using real-time PCR with the allele-specific primers and probes. Internal positive controls were included in each well, and an automatic interpretative algorithm was applied. This system was validated using 244 clinical samples and 2 commercial DNA samples that had been previously genotyped using PCR-direct sequencing. Results. All of the obtained results are concordant with those of the reference method. All of the internal positive control reactions were successful. The allele frequency of TPMT 3C was 2.05% (10 of 488 alleles). All of the patients with variant alleles were heterozygotes, and no homozygotes were detected. No TPMT 2, 3A, or 3B alleles were observed in this Korean population., Conclusion: This rapid, accurate, and user-friendly genotyping system can be readily used to improve the efficacy and safety of thiopurine treatments in clinical practice.

Specific toxicity test is a major quality control test for acellular pertussis (aP) vaccines performed by manufacturers and regulatory authorities. The 'mouse body weight gain test (MWGT)', the 'leukocytosis-promoting test (LPT)' and the 'histamine sensitization test (HIST)' have been conducted to check the specific toxicity of all batches of aP vaccines used in Korea through the national quality control program, which requires a lot of animals, labor and time. In this study, test results obtained in the past 9 y from a total of 258 lots of aP vaccines were examined retrospectively to evaluate the three test methods. A pairwise comparison of the test results indicated a good correlation between LPT and HIST, whereas MWGT showed no correlation with either LPT or HIST. Moreover, the reversion to toxicity was higher than the residual toxicity in the majority of lots tested by HIST, which indicated that the histamine-sensitizing toxicity, although rated within a safe range, increased during the vaccine storage. Thus, the vaccine safety test results accumulated in the past might be useful for the improvement of test protocols.

Pheochromocytoma is a tumor that originates from the adrenal cortex and sympathetic chains. Most pheochromocytomas are sporadic, whereas others occur as hereditary syndromes. Familial pheochromocytoma has been frequently found in association with various mutations in genes of the succinate dehydrogenase family. A 21-year-old Korean male presented with recurrent chest tightness, severe headache, and hypertension. He was diagnosed as pheochromocytoma based on a 24-hour urine test, abdominal computed tomography, and (131)I-MIBG scintigraphy. Genomic DNA was extracted from the patient's whole blood. Primers covering all the coding regions and flanking introns of succinate dehydrogenase (SDH) B, C and D genes were designed and synthesized, and a DNA sequence analysis was performed using the polymerase chain reaction. Direct sequencing of the SDHB gene revealed a deletion of nucleotide 757 (thymidine) in exon 7. This thymidine deletion caused a shift in the reading frame that created a downstream stop codon and a truncated product (p.Cys253ValfsX5). Although the patient had no family history of pheochromocytoma, his father had the same mutation. We report a novel SDHB gene mutation from a Korean family with pheochromocytoma. This is the first report of pheochromocytoma with a confirmed SDHB germline mutation in Korea.

Parasitological examination of samples from tombs of the Korean Joseon Dynasty (1392-1910) could be helpful to researchers in understanding parasitic infection prevalence in pre-industrial Korean society. Whereas most of our previous parasitological studies revealed the presence of ancient parasite eggs in coprolites of Korean mummies, a sample from a man living in late 17th century Korea proved to be relatively unique in possessing what appeared to be several species of parasite larvae. The larvae identified included Strongyloides stercoralis and Trichostrongylus spp., along with eggs of Ascaris lumbricoides, Trichuris trichiura, and Paragonimus westermani. Since ancient parasite larvae retain enough morphology to make proper species identification possible, even after long burial times, the examination of parasite larvae within ancient samples will be conducted more carefully in our future work.

The Department of Laboratory Medicine at Asan Medical Center provides a special one-stop service to allow both doctors and outpatients to receive routine outpatient test results in a timely manner within 1 hr. We developed a new Laboratory Information System (LIS)-based monitoring system that records the laboratory turnaround time (TAT) in 3 phases and analyzes the time to complete each phase with relevant specimens. TAT is subdivided into preanalytical, analytical, and postanalytical phases based on the 4 time points when data are entered automatically into the LIS. The average TAT for 13,594 outpatient routine chemistry specimens with the one-stop service was 43.6+/-7.7 min. Completion times of the preanalytical, analytical, and postanalytical phases were 29.7+/-6.9, 13.9+/-4.1, and 0.02+/-0.13 min, respectively; 98.0% of the specimens were reported within 60 min. The remaining 2.0% were reported after 60 min with an average TAT of 68.7+/-11.3 min. Preanalytical phase delays were primarily responsible for the specimens reported between 60 and 90 min, and analytical phase delays were largely responsible for the few specimens (0.2%) reported after 90 min. For specimens reported between 60 and 90 min, the preanalytical phase was found to need improvement in order to shorten TAT; the main target for improvement was identified as the "waiting time for phlebotomy" step.

We devised a complementary quantitative method for gestational diabetes (GDM) that uses the area under the curve (AUC) of the results of the oral glucose tolerance test (OGTT), and evaluated its efficacy in predicting neonates that would be large for gestational age (LGA). The study subjects were 648 pregnant women. The AUC-OGTT (concentration x time) was calculated from the 100-g OGTT results. The incidence of LGA according to each range of the AUC-OGTT was estimated and odds ratios were analyzed using multiple logistic regression analysis.The incidence of LGA increased with the AUC-OGTT value and was 0% for AUC<300, 7.8% for 300-400, 14.9% for 400-500, 20.8% for 500-600, and 45.5% for > or = 600. The odds ratio of LGA increased by approximately two-fold with an increase of 100 in the AUC-OGTT. The results indicated that the AUC-OGTT can be used to quantify the risk of LGA in GDM. The AUC-OGTT could complement a diagnosis of GDM using conventional diagnostic criteria.

Background and Aim: Infection of Helicobacter pylori is viewed as a major driver of progression to the precancerous state or to gastric cancer. This study was performed to investigate the effect of H. pylori infection on gastric cancer development and to determine to what extent H. pylori eradication is likely to reduce the prevalence of gastric cancer., Methods: Gastric cancer development was investigated in 1790 Korean subjects who underwent gastroscopy and H. pylori testing between 1992 and 1998. The effects of H. pylori-positive and eradicated states on gastric cancer development were analyzed., Results: Gastric cancer developed in 5 of the study cohort during a mean follow-up period of 9.4 years. All of these patients were positive for H. pylori infection, and 4 of the 5 had antral intestinal metaplasia (IM) at the time of study enrollment. One of these 5 patients was in an eradicated state when the gastric cancer was diagnosed, and had histologic IM before eradication therapy was performed. Gastric cancer was found to develop 10.9 times more frequently in the presence of IM than in its absence., Conclusions: The present study shows a close relationship between H. pylori infection and IM, and between IM and the development of gastric cancer. In addition, our finding suggests that chronic H. pylori infection looks like an important risk factor for the development of gastric cancer in Korea, where the prevalence of H. pylori remains high. This study indicates that to prevent gastric cancer H. pylori eradication is best performed before the development of IM.

Physicians need to respond to critical value alerts in a timely and appropriate manner. We evaluated the clinical usefulness of a short message service (SMS) system for notifying physicians of critical values by sending a text message to their personal data assistant (PDA) phones. The clinical response times and clinical response rates to notifications of critical hyperkalemia in inpatients in 2001, when the callback system alone was used to alert physicians, were compared to those in 2005, when the SMS alert system was used in addition to the callback system. The clinical response time to SMS alerts of critical hyperkalemia sent to PDA phones in 2005 was remarkably shorter than the response time to alerts sent using the callback system alone in 2001. With the help of the SMS system for sending critical value alerts to PDA phones, corrective actions could be taken more promptly and patient care was improved.

Aim of the Study: Dangnyohwan (DNH) has been used for treatment of diabetes mellitus. However, the exact cellular and molecular mechanisms underlying the beneficial effects of DNH are not well understood. Therefore, we investigated how DNH improves hyperglycemia and insulin resistance in obese-type diabetes model., Methods and Materials: We examined the effect of DNH on the expression of glucose transporter 4 (GLUT4), GLUT4 translocation, and glucose transport activity in muscle and adipose tissues from Otsuka Long-Evans Tokushima Fatty (OLETF) and Long-Evans Tokushima Otsuka (LETO) rats., Results: DNH ameliorated hyperglycemia and impaired glucose tolerance (IGT) observed in 26- and 42-week-old male OLETF rats. The basal and insulin-stimulated [14C]2-Deoxyglucose (2DG) uptake was significantly increased in adipocytes from DNH-treated OLETF rats, as compared with untreated OLETF rats. The expression level of GLUT4 was markedly decreased (by 90-95%) in the adipose tissue of OLETF rats, whereas DNH treatment drastically increased the expression of GLUT4 within 8 weeks. DNH improved GLUT4 recruitment stimulated by insulin in both the 26- and 42-week-old OLETF rat adipocytes., Conclusion: These results suggest that DNH could exert the beneficial effects on hyperglycemia and insulin resistance by increasing the expression and insulin-stimulated translocation of GLUT4 in OLETF rat adipocytes.

Objective: The number of adult hepatitis A cases has progressively been increasing during the last several years in Korea. The aim of the present study was to describe the recent clinical features of hepatitis A and the seroprevalence of hepatitis A virus (HAV), and to discuss HAV vaccine strategy in Korea., Methods: Retrospective analysis of clinical characteristics of hepatitis A from 109 patients consecutively enrolled at a community hospital between 2003 and 2006 as well as cross-sectional study of seroprevalence of HAV from 307 patients of hospital population group during the same period were performed., Results: Most hepatitis A cases were young adults in their twenties or thirties, and the severity of the disease was related to the age of patients. The seroprevalence of HAV was 62%, which was dependent on the age of patients. HAV seroepidemiology in Korea is rapidly changing and a growing number of young adults are susceptible to HAV infection., Conclusions: The clinical features and the epidemiological shift of HAV urge Korea, as well as other countries which are experiencing similar issues, to promote childhood vaccination and consider catch-up vaccination for adolescents and young adults., (Copyright 2008 S. Karger AG, Basel.)

A new ice bug species, Galloisiana odaesanensis sp. nov., is described from Mt. Odae, Pyeongchang-gun, Gangwon-do, South Korea. This species resembles the G. yuasai group in having a short body (less than 20 mm), distinct compound eyes, fewer than 35 antennomeres, and seven or eight cercomeres. The species is, however, clearly distinguished from the G. yuasai group by the following characters: slightly curved supra-anal plate with dull apical margin; rectangular pronotum that is straight on the posterior; 3rd antennomere 1.7 times as long as the 2nd. The distribution of the genus Galloisiana is discussed and a key for Galloisiana species is presented.

The immobilized cell using self-assembled synthetic oligopeptide was applied to the electrochemical detection of pathogen infection. Thin films based on cysteine-terminated synthetic oligopeptides were fabricated for the immobilization of HeLa cell on gold (Au) substrate. Layer formation and immobilization of the cell were investigated with surface plasmon resonance (SPR) and electrochemical impedance spectroscopy (EIS). Experimental results showed that the thin film of cysteine-terminated synthetic oligopeptide was successfully fabricated and it could be applied for the immobilization of HeLa cells. The adhered living cell was exposed to E. coli O157:H7, which induced the change of SPR angle and electrochemical impedance signal. The proposed cell immobilization method using self-assembly technique can be applied to construct the cell microarray for on-site pathogen monitoring.

DNA in most cells is regularly damaged by endogenous and exogenous mutagens. Unrepaired damage can result in apoptosis or may lead to unregulated cell growth and cancer. Inheritance of genetic variants at one or more loci results in reduced DNA repair capacity. This hospital-based case-control study examined whether polymorphisms in the DNA repair gene X-ray repair cross-complementing groups 1 (XRCC1) (Arg194Trp[C > T], Arg280His[G > A] and Arg399Gln[G > A]) play a role in susceptibility to skin cancer. We genotyped these polymorphisms for 212 histopathologically confirmed skin cancer cases (n = 114 basal cell carcinoma, n = 98 squamous cell carcinoma) and 207 age- and sex-matched healthy control cases in Korea. We found that individuals with the Arg/Gln and Arg/Gln + Gln/Gln genotypes at XRCC1 Arg399Gln(G > A) had an approximately 2-fold increased risk of basal cell carcinoma compared to individuals with the Arg/Arg genotype (adjusted odds ratio [AOR] = 2.812, 95% confidence interval [CI] 1.32-5.98, and AOR = 2.324, 95% CI 1.11-4.86). However, we observed that the 194Trp allele of the Arg194Trp(C > T) polymorphism was inversely associated with squamous cell carcinoma risk (Trp/Trp, AOR = 0.06, 95% CI 0.006-0.63). Our data suggest that the Arg194Trp and Arg399Gln polymorphisms may be differentially associated with skin cancer risk.

Background: The survival rate of grafted hairs in hair transplantation has been frequently discussed by many hair-transplant surgeons. Several factors, including skill of doctors and assistants and the amount of perifollicular connective tissue, are suggested to have predictive values in foretelling the eventual quantity of hair growth., Objective: The purpose of this study is to determine survival rate according to density of Korean one-hair follicular units grafted with a KNU implanter., Methods: We designed four templates of 1 cm2 made by tattooing two templates on each side of empty frontoparietal recesses in four Korean patients with male pattern alopecia (beyond Norwood-Hamilton-Type IIIa). One-hair follicular units were prepared from occiput and we grafted 20, 30, 40, and 50 one-hair follicular units using a KNU implanter on each template, respectively, and counted the number of surviving hairs after 10 months., Results: The survival rate of 20 and 30 grafts per template was higher than that of 40 and 50 grafts., Conclusion: We think that 30 one-hair follicular units grafted with a KNU implanter is the proper density for better survival in Korean hair transplantation, and repeated sessions will be necessary for a better final result. However, we need further evaluation with a larger number of participants to overcome the small sample size and limitation of one-hair follicular unit grafts. The authors have indicated no significant interest with commercial supporters.

Severance Hospital categorizes nursing records and organizes an information system in which nurses can easily and accurately utilize record information. This research will introduce the basic compositions of the nursing process: situational variables (diagnostic situations, factor), index of factor (results of diagnostic situations, value) and the connecting frame for nursing diagnosis.

A new species, Attheyella namkungi sp. nov., is described from Gosu cave at Danyang, Chungcheongbuk-do, South Korea. This species bears a superficial resemblance to A. coreana Miura, 1969 in having a 2-segmented mandibular palp with only four smooth apical setae, and in the armature formulae of the antennary exopod and thoracic legs. However the new species is clearly distinguishable by the non-sexually dimorphic caudal rami, two long plumose setae and a short seta on leg 6, and the absence of the setular row at the inner lateral margin of each caudal ramus. The new species is characterized from other congeners by having two adjacent inner spines on female leg 3 endopod-2, the caudal ramus twice as long as its width, absence of a barbed apophysis on male leg 3 endopod-2, and the seta number of legs 5 and 6. A key to the Korean species of the genus Attheyella is provided.

To analyze the clinicopathologic characteristics of childhood non-Hodgkin's lymphoma (NHL) associated with Epstein-Barr virus (EBV), EBER in situ hybridization was performed in 80 cases of NHLs. EBER-positive lymphomas account for 25% (20/80) and include NK/T-cell lymphoma (6/6), aggressive NK-cell leukemia (1/1), peripheral T cell lymphoma (5/11), diffuse large B-cell lymphoma (5/14), hydroa-like T-cell lymphoma (1/1), marginal zone B-cell lymphoma (1/2), and post-transplantation lymphoproliferative disorder (1/1). Other types including 19 cases of Burkitt's lymphoma were negative. For 9 EBER-positive cases, immunohistochemical staining for LMP-1, and EBNA-2 was performed to determine the EBV latency pattern. Two of nine EBER-positive cases expressed both LMP-1 and EBNA-2. Clinically, patients with EBV-positive B-cell lymphomas were cured with chemotherapy, whereas EBV-associated NK- and T cell lymphomas pursued fatal clinical course. In conclusion, EBVs infected in childhood NHLs are frequently associated not only with NK- and T- cell lymphomas but also large B-cell lymphomas.

Chronic granulomatous disease (CGD) is a fatal genetic disorder in which phagocytes fail to produce antimicrobial superoxide because of NADPH oxidase deficiency. Molecular defects in CYBB gene causing X-linked CGD are responsible for about 70% of all cases. This study was done to confirm genetic defects of CYBB gene in five Korean patients who were highly suggestive of having CGD by clinical history. We performed initial screening for five unrelated Korean patients using single strand conformation polymorphism (SSCP) and then selective sequencing for the regions involving the abnormal bands. Activated NBT tests revealed that all patients were X-linked. SSCP analysis for CYBB gene showed abnormal bands in all patients. The molecular defects of five patients were as follows: c.1663insT, c.1111-1G>T, c.39&#95;40insG, c.927delC and c.434T>C mutation. This result will help the families with prenatal diagnosis or genetic counseling.

A new interstitial copepod of the family Laophontidae was found in the samples from a sandy beach at Taean, west coast of Korea. This species was described and named as Quinquelaophonte koreana sp. nov. Present new species is clearly distinguishable from its congeners with the combined characters of the short caudal ramus and its short ornamented seta V, two setae on the antennary exopod, and small rounded rostrum. Q. koreana sp. nov. is the first record of Quinquelaophonte from the Northeast Asian coast.