A Case of Skin Burns Occurring during Laparoscopic Surgery

Skin burn injury from light cables is a rare complication of laparoscopic surgery. We report the case of a 57-year-old female who underwent laparoscopic-assisted right hemicolectomy under general anesthesia. During surgery, the anesthesiologist discovered that the tip of the light cable, with the light source powered on, penetrated the surgical drape and was positioned on the right forearm of the patient, where a bulla measuring 2.0× 2.5 cm in size and a second-degree burn were identified. All medical personnel participating in laparoscopic and arthroscopic procedures should always be aware that the light cable can cause burns to the patient. Additionally, after connecting the light cable to the scope, the light source should be activated. The light cable should not be placed around the patient or on the surgical drape while the light source is active. Immediately after completing the surgery, the power to the light source should be turned off, and the light cable should be placed in a safe place.

Comparison of the Agitation-Reducing Effects of Esmolol and Lidocaine in Pediatric Strabismus Surgery: A Double-Blind, Randomized Clinical Study

Objective@#Agitation is a common symptom in children undergoing surgery, especially when surgeries are performed under sevoflurane and when patients undergo strabismus surgery. Because agitation can increase the risk of falls and lacerations on surgical sites and can delay discharge from the recovery room, adopting measures to reduce the incidence of agitation is essential. This study aimed to compare the agitation-reducing effects of lidocaine and esmolol administered individually or as a combination. @*Methods@#We included 80 patients scheduled to undergo strabismus surgery. Thiopental and sevoflurane were administered to induce general anesthesia. Group EL received lidocaine (2 mg/kg) right after the end of surgery and esmolol (0.5 mg/kg) immediately after recovery from anesthesia after turning the anesthetic gas off; group L received lidocaine at 2 mg/kg right after the end of surgery and did not receive esmolol, group E did not receive lidocaine at the end of the surgery but received esmolol at 0.5 mg/kg right after recovery from anesthesia, and group C received neither esmolol nor lidocaine. Agitation severity was assessed using the objective pain score, Pediatric Anesthesia Emergence Delirium Scale immediately after recovery from anesthesia and until discharge from the recovery room. @*Results@#Groups L and EL showed significantly lower agitation than groups E and C right after recovery from anesthesia, right after arrival to the recovery room, and 10 minutes after arrival to the recovery room (P 0.05). @*Conclusion@#Compared to the groups without lidocaine administration, groups L and EL, which received 2 mg/kg lidocaine, showed a higher level of reduction in agitation immediately after recovery from anesthesia and right after arrival to the recovery room (P < 0.05).

Single-nucleotide polymorphismbased epidemiological analysis of Korean Mycobacterium bovis isolates

Background@#Bovine tuberculosis (TB) is caused by Mycobacterium bovis, a well-known cause of zoonotic tuberculosis in cattle and deer, and has been investigated in many physiological and molecular studies. However, detailed genome-level studies of M. bovis have not been performed in Korea. @*Objectives@#To survey whole genome-wide single-nucleotide polymorphism (SNP) variants in Korean M. bovis field isolates and to define M. bovis groups in Korea by comparing SNP typing with spoligotyping and variable number tandem repeat typing. @*Methods@#A total of 46 M. bovis field isolates, isolated from laryngopharyngeal lymph nodes and lungs of Korean cattle, wild boar, and Korean water deer, were used to identify SNPs by performing whole-genome sequencing. SNP sites were confirmed via polymerase chain reaction using 87 primer pairs. @*Results@#We identified 34 SNP sites with different frequencies across M. bovis isolates, and performed SNP typing and epidemiological analysis, which divided the 46 field isolates into 16 subtypes. @*Conclusions@#Through SNP analysis, detailed differences in samples with identical spoligotypes could be detected. SNP analysis is, therefore, a useful epidemiological tracing tool that could enable better management of bovine TB, thus preventing further outbreaks and reducing the impact of this disease.

Protection of palmitic acid treatment in RAW264.7 cells and BALB/c mice during Brucella abortus 544 infection

Background@#We previously elucidated the protective mechanism of Korean red ginseng oil (RGO) against Brucella abortus infection, and our phytochemical analysis revealed that palmitic acid (PA) was an abundant component of RGO. Consequently, we investigated the contribution of PA against B. abortus. @*Objectives@#We aimed to investigate the efficacy of PA against B. abortus. infection using a murine cell line and a murine model. @*Methods@#Cell viability, bactericidal, internalization, and intracellular replication, western blot, nitric oxide (NO), and superoxide (O2 - ) analyses and flow cytometry were performed to determine the effects of PA on the progression of B. abortus. infection in macrophages. Flow cytometry for cytokine analysis of serum samples and bacterial counts from the spleens were performed to determine the effect of PA in a mouse model. @*Results@#PA did not affect the growth of B. abortus.. PA treatment in macrophages did not change B. abortus. uptake but it did attenuate the intracellular survivability of B. abortus.. Incubation of cells with PA resulted in a modest increase in sirtuin 1 (SIRT1) expression.Compared to control cells, reduced nitrite accumulation, augmented O2 - , and enhanced pro-inflammatory cytokine production were observed in PA-treated B. abortus.-infected cells.Mice orally treated with PA displayed a decreased serum interleukin-10 level and enhanced bacterial resistance. @*Conclusions@#Our results suggest that PA participates in the control of B. abortus. within murine macrophages, and the in vivo study results confirm its efficacy against the infection. However, further investigations are encouraged to completely characterize the mechanisms involved in the inhibition of B. abortus. infection by fatty acids.

Single-nucleotide polymorphismbased epidemiological analysis of Korean Mycobacterium bovis isolates

Background@#Bovine tuberculosis (TB) is caused by Mycobacterium bovis, a well-known cause of zoonotic tuberculosis in cattle and deer, and has been investigated in many physiological and molecular studies. However, detailed genome-level studies of M. bovis have not been performed in Korea. @*Objectives@#To survey whole genome-wide single-nucleotide polymorphism (SNP) variants in Korean M. bovis field isolates and to define M. bovis groups in Korea by comparing SNP typing with spoligotyping and variable number tandem repeat typing. @*Methods@#A total of 46 M. bovis field isolates, isolated from laryngopharyngeal lymph nodes and lungs of Korean cattle, wild boar, and Korean water deer, were used to identify SNPs by performing whole-genome sequencing. SNP sites were confirmed via polymerase chain reaction using 87 primer pairs. @*Results@#We identified 34 SNP sites with different frequencies across M. bovis isolates, and performed SNP typing and epidemiological analysis, which divided the 46 field isolates into 16 subtypes. @*Conclusions@#Through SNP analysis, detailed differences in samples with identical spoligotypes could be detected. SNP analysis is, therefore, a useful epidemiological tracing tool that could enable better management of bovine TB, thus preventing further outbreaks and reducing the impact of this disease.

Protection of palmitic acid treatment in RAW264.7 cells and BALB/c mice during Brucella abortus 544 infection

Background@#We previously elucidated the protective mechanism of Korean red ginseng oil (RGO) against Brucella abortus infection, and our phytochemical analysis revealed that palmitic acid (PA) was an abundant component of RGO. Consequently, we investigated the contribution of PA against B. abortus. @*Objectives@#We aimed to investigate the efficacy of PA against B. abortus. infection using a murine cell line and a murine model. @*Methods@#Cell viability, bactericidal, internalization, and intracellular replication, western blot, nitric oxide (NO), and superoxide (O2 - ) analyses and flow cytometry were performed to determine the effects of PA on the progression of B. abortus. infection in macrophages. Flow cytometry for cytokine analysis of serum samples and bacterial counts from the spleens were performed to determine the effect of PA in a mouse model. @*Results@#PA did not affect the growth of B. abortus.. PA treatment in macrophages did not change B. abortus. uptake but it did attenuate the intracellular survivability of B. abortus.. Incubation of cells with PA resulted in a modest increase in sirtuin 1 (SIRT1) expression.Compared to control cells, reduced nitrite accumulation, augmented O2 - , and enhanced pro-inflammatory cytokine production were observed in PA-treated B. abortus.-infected cells.Mice orally treated with PA displayed a decreased serum interleukin-10 level and enhanced bacterial resistance. @*Conclusions@#Our results suggest that PA participates in the control of B. abortus. within murine macrophages, and the in vivo study results confirm its efficacy against the infection. However, further investigations are encouraged to completely characterize the mechanisms involved in the inhibition of B. abortus. infection by fatty acids.

A serological study of severe fever with thrombocytopenia syndrome using a virus neutralization test and competitive enzyme-linked immunosorbent assay

Severe fever with thrombocytopenia syndrome (SFTS) is caused by the SFTS virus (SFTSV). The SFTSV appears to have a wide host range, as SFTSV-positive ticks have been isolated from both farm animals and wild rodents. Therefore, it is important to monitor SFTSV-positive animals to prevent the transmission of SFTSV from animals to humans. Previously, we developed a competitive enzyme-linked immunosorbent assay (cELISA) to detect SFTSV-specific antibodies from field animals and compared the cELISA results to those from an indirect immunofluorescence assay (IFA). In this study, cELISA results were compared to and evaluated against the results from both an IFA and a virus neutralization (VN) test of 193 bovine serum samples (including two bovine positive control sera) and 70 horse serum samples. The consistency (98.9%) between cELISA and VN results was higher than that (97.4%) between cELISA and IFA for the bovine serum samples. Similarly, for the horse serum samples, the consistency (88.6%) between cELISA and VN results was higher than that (84.3%) between the cELISA and IFA. These findings indicate that our newly developed cELISA can be used for surveillance or epidemiological studies of SFTSV in animals.

Development and evaluation of a competitive enzyme-linked immunosorbent assay using a monoclonal antibody for diagnosis of severe fever with thrombocytopenia syndrome virus in bovine sera

Severe fever with thrombocytopenia syndrome (SFTS) caused by the SFTS virus (SFTSV), a phlebovirus in the family Bunyaviridae, is an emerging tick-borne infectious disease that impacts humans. This disease manifests as a decreased blood cell count and multi-organ failure, with a case-fatality rate of more than 12% in China. Because vaccines or antiviral drugs for the treatment of this disease are not available, monitoring the SFTS circulation in animals and controlling the tick-mammal cycle are important for preventing SFTS. Monoclonal antibodies against the recombinant nucleoprotein of SFTSV were generated to develop a competitive enzyme-linked immunosorbent assay (cELISA) for the detection of antibodies against SFTSV infection in cattle. The specificity and sensitivity of cELISA was assessed by comparing the results of this assay to those of an immunofluorescence assay (IFA). The results of the cELISA using 416 field bovine serum samples and laboratory-immunized positive sera showed 98.1% consistency with those of the IFA. The cELISA used in this study did not show cross-reactivity with antisera against other viral cattle diseases. The cELISA presented in this study can be applied to detect antibodies against SFTSV in cattle.

Prevalence of Congenital Heart Defects Associated with Down Syndrome in Korea

Congenital heart defect (CHD) is common in infants with Down syndrome (DS), which is the principle cause of mortality. However, there is no data available for the frequency and types of CHD in infants with DS in Korea. We investigated the frequency of CHD in infants with DS in Korea. After the survey on birth defects was conducted throughout the country, the prevalence of CHD in DS in 2005-2006 was calculated. This study was conducted based on the medical insurance claims database of the National Health Insurance Corporation. The number of total births in Korea was 888,263 in 2005-2006; of them, 25,975 cases of birth defects were identified. The prevalence of DS was 4.4 per 10,000 total births, accounting for 1.5% of all birth defects. Of the 394 infants with DS, 224 (56.9%) had a CHD. Atrial septal defect was the most common defect accounting for 30.5% of DS followed by ventricular septal defect (19.3%), patent duct arteriosus (17.5%), and atrioventricular septal defect (9.4%). Our study will be helpful to demonstrate the current status of DS and to identify the distribution of CHD in infants with DS in Korea.

Changes in Statistics of Maternal Death in Korea (1995-2010) / 대한주산의학회잡지

PURPOSE: In the past 15 years in Korea, there have been findings reporting a remarkable improvement in reduction of neonatal, infant, and perinatal mortality rates. Consequently, this study was conducted to examine the trends of maternal mortality ratio and observe if it has also improved over time. METHODS: The trends of maternal deaths from 1995 to 2010 in Korea were analyzed based on the following materials: 1) surveys of maternal death rate conducted by the Korea Institute for Health and Social Affairs (1995-2008), 2) statistical report of causes of death in Korea by Statistics Korea (2007-2010). RESULTS: The number of maternal deaths and the maternal mortality ratio declined steadily from 1995 to 2010 in Korea; however, they have increased slightly since 2008. The direct maternal mortality ratio was reduced when comparing the direct proposition maternal death ratio of 16:4 in 1995 and of 9.1:5 in 2010. The maternal mortality ratio tended to be higher in women from 35-39 years old age group, 40 years or older. Gangwon province had the highest maternal mortality ratio of all provinces in Korea. In 2009, the average maternal mortality ratio for the OECD nations was 10.1 while it was 10.8 for Korea, a little higher than the OECD average. CONCLUSION: Although the maternal mortality ratio improved by a significant reduction between 1995 and 2010 in Korea, the level is still about average for the OECD countries. It appears that even more efforts should be made to improve maternal mortality ratio compared to the progression in the areas of neonatal and infant mortality rates.

Prevalence of Birth Defects in Korean Livebirths, 2005-2006

We investigated the livebirths prevalence and occurrence pattern of birth defects in Korea. After the survey on birth defects was done in 2,348 medical institutions around the nation, the birth defect prevalence of livebirths in 2005-2006 was calculated. This study was based on the medical insurance claims database of the National Health Insurance Corporation. The number of livebirths in Korea was 883,184 from 2005-2006, and 25,335 cases of birth defects were notified to our study, equivalent to a prevalence of 286.9 per 10,000 livebirths. Anomalies of the circulatory system were the most common defects, accounting for 43.4% of birth defects with a prevalence of 124.5 per 10,000 livebirths. It was followed by the musculoskeletal system anomalies, the digestive system anomalies, and the urinary system anomalies. The five major birth defects based on the ranking of prevalence were atrial septal defect, ventricular septal defect, hydronephrosis, patent ductus arteriosus, and cleft lip/palate. Birth defects in livebirths were associated with a high proportion of low birthweight, prematurity, multiple births and advanced maternal age. The prevalence of birth defects in Korea is similar to or lower than those reported in developed countries. Our study suggests baseline data to explain the current status of birth defects and to establish a registry system of birth defects in Korea.

Ovarian malignancy in pregnancy: Experience for 17 years / 대한주산의학회잡지

OBJECTIVE: The aim of this study was to evaluate the clinical course and pregnancy outcome in patients who had ovarian cancer diagnosed during pregnancy. METHODS: Review of medical records of 10 cases of patients who have ovarian cancer diagnosed during pregnancy at three affiliated hospitals in the Catholic Medical Center from January 1991 to December 2007 was done. RESULTS: Among 10 cases diagnosed as ovarian cancer during pregnancy, six cases were in the first trimester, one case in the second trimester, and 3 cases in the third trimester. Six cases did not show any specific symptoms at diagnosis and seven cases showed malignant characteristics on ultrasonography. Pathologic evaluation showed 2 clear cell tumors in stage IIIb and Ia, 1 germ cell tumor in Ic, 1 immature teratoma in Ic, and 2 serous adenocarcinoma in Ic and Ic, 2 borderline serous adenocarcinoma, and 2 borderline mucinous adenocarcinoma. Three cases with epithelial ovarian cancer in stage I did not receive chemotherapy. Two cases in non-epithelial ovarian malignancy and 1 stage IIIb epithelial ovarian cancer received chemotherapy. In one case, chemotherapy was performed during pregnancy and a healthy child was delivered. Five in 10 cases were lost in long term follow-up and 5 cases including stage IIIb case, remain without evidence of recurrent disease. CONCLUSION: If early diagnosis and treatment are performed, ovarian cancer diagnosed during pregnancy has favorable prognosis. So, delay the treatment of ovarian cancer due to pregnancy should not be permitted and proper chemotherapy during pregnancy should be considered if necessary.

The comparison of beta-hCG levels according to treatment modalities in tubal pregnancy / 대한주산의학회잡지

OBJECTIVE: The aims of this study were to evaluate the effect of the methotrexate (MTX) method by comparing the change of the serum beta-hCG level between the MTX method and salpingectomy for treating tubal pregnancy, furthermore by analyzing differences between the MTX success group and the failure group, and to provide helps in establishing criteria for choosing the MTX method. METHODS: Medical records of the 118 patients who were diagnosed with tubal pregnancy were reviewed retrospectively for the period of January 2006 to December 2007 at Kangnam St. Marys Hospital. RESULTS: Between the MTX success group and the failure group, no difference was observed in pregnancy duration, but statistically significant differences were observed in the size of hematoma and the quantity of hemoperitoneum at the site of tubal pregnancy in ultrasonography and in the serum beta-hCG level (p<0.05). Compared with salpingectomy, the MTX method showed the patterns of a low decrease rate of serum beta-hCG level after treatment and even its increase during the early period of treatment, but the serum beta-hCG level decreased rapidly from Day 7 after treatment and became equal to that of salpingectomy on Day 28 after treatment. CONCLUSION: The size of hematoma and the quantity of hemoperitoneum at the site of tubal pregnancy and the serum beta-hCG level before treatment are important factors for success in the MTX method. The MTX method may be safe and effective relatively in hemodynamically stable tubal pregnancy patients, who need preserve the salpinx particularly.

Significance of prenatal radiologic diagnosis of the central nervous system anomalies / 대한주산의학회잡지

OBJECTIVE: The present study compared the findings of ultrasonography and MRI in the prenatal diagnosis of congenital central nervous system anomalies and identified the merits of MRI. METHODS: We retrospectively analyzed the medical records of neonates diagnosed with congenital central nervous system anomaly after birth born at the Department of Obstetrics and Gynecology in Kangnam St. Marys Hospital during the period from January 1997 to April 2008, and compared the findings of prenatal ultrasonography and MRI with the results of postnatal diagnosis. RESULTS: There were a total of 13 neonates postnatally diagnosed with congenital central nervous system anomaly, and 6 of them had prenatal MRI. Among them, ventriculomegaly and hydrocephalus were observed in 3 cases, arachnoid cyst in 2 cases, and megacisterna magna in 1 case. Supplementary information was available for all the 6 cases, and diagnosis based on the supplementary information was closer to postnatal diagnosis. CONCLUSION: In fetuses in which congenital central nervous system anomaly is observed in ultrasonography, prenatal MRI can provide supplementary information and enable more accurate diagnosis. This can be helpful in counseling the guardians and deciding treatment modality.

Association study of 5-HTT gene polymorphism with fear during childbirth / 대한산부인과학회지

The fear and anxiety in the biological processes of childbirth have been of clinical interest, but the studies addressing this subject are rare, particularly where the outcome of the pregnancy has been favourable. In this study, single nucleotide polymorphisms were studied for understanding the fear during childbirth in 534 Korean pregnant women. The frequencies of each SNP were 5-HTT -15375 insdel (44 bp) 0.24, -1002A>C 0.10, -922A>C 0.11, +18784A>C 0.073 in Korean pregnant women (n=534). No polymorphisms was found in 5-HTT +3746G>C The relationship between the fear during childbirth and genetic polymorphisms was investigated by multiple regression analysis adjusting for parity in 293 women who gave birth to a child vaginally and made a reply to Delivery Fear Scale (DFS) which was the measuring instrument for the fear during childbirth among 534 Korean pregnant women. There was no genetic association between the 5-HTT gene polymorphism and fear during childbirth. The results of this study show that the psychological, social, environmental factors play the major role in the fear during childbirth whereas this gene (5-HTT) most likely has only a minor effect in its etiology. And other genes and the interactions between them have been thought to make complex effects. In order to identify the fear during childbirth, further studies will have to be focused on the comprehensive research of the social, psychological, environmental factors and the interaction of the connected genes.