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Viral load and the duration of viral shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are important determinants of the transmission of coronavirus disease 2019.In this study, we examined the effects of viral doses on the lung and spleen of K18-hACE2 transgenic mice by temporal histological and transcriptional analyses. Approximately, 1×105 plaque-forming units (PFU) of SARS-CoV-2 induced strong host responses in the lungs from 2 days post inoculation (dpi) which did not recover until the mice died, whereas responses to the virus were obvious at 5 days, recovering to the basal state by 14 dpi at 1×102 PFU. Further, flow cytometry showed that number of CD8+ T cells continuously increased in 1×102 PFU-virusinfected lungs from 2 dpi, but not in 1×105 PFU-virus-infected lungs. In spleens, responses to the virus were prominent from 2 dpi, and number of B cells was significantly decreased at 1×105PFU; however, 1×102 PFU of virus induced very weak responses from 2 dpi which recovered by 10 dpi. Although the defense responses returned to normal and the mice survived, lung histology showed evidence of fibrosis, suggesting sequelae of SARS-CoV-2 infection. Our findings indicate that specific effectors of the immune response in the lung and spleen were either increased or depleted in response to doses of SARS-CoV-2. This study demonstrated that the response of local and systemic immune effectors to a viral infection varies with viral dose, which either exacerbates the severity of the infection or accelerates its elimination.
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Fulminant hepatic failure (FHF) is a rare but fatal disease with a 40%-80% mortality, often requiring liver transplantation, which is hard to perform in children. A therapeutic intervention alternative to liver transplantation is an extracorporeal artificial liver support system. Molecular Adsorbent Recirculation Systems® (MARS) has emerged as a bridge therapy for adult FHF, whereas in pediatric FHF, there have been a small number of cases of implementing MARS. Recently, we witnessed the recovery of 2 teenagers with FHFs caused by acetaminophen and a diet aid. Both patients were treated uneventfully, with early use of MARS. These cases suggest that early use of MARS may be a promising therapeutic intervention in pediatric drug-induced FHF.
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In a conventional two-dimensional (2D) culture method, cells are attached to the bottom of the culture dish and grow into a monolayer. These 2D culture methods are easy to handle, cost-effective, reproducible, and adaptable to growing many different types of cells. However, monolayer 2D cell culture conditions are far from those of natural tissue, indicating the need for a threedimensional (3D) culture system. Various methods, such as hanging drop, scaffolds, hydrogels, microfluid systems, and bioreactor systems, have been utilized for 3D cell culture. Recently, external physical stimulation-based 3D cell culture platforms, such as acoustic and magnetic forces, were introduced. Acoustic waves can establish acoustic radiation force, which can induce suspended objects to gather in the pressure node region and aggregate to form clusters. Magnetic targeting consists of two components, a magnetically responsive carrier and a magnetic field gradient source. In a magnetic-based 3D cell culture platform, cells are aggregated by changing the magnetic force. Magnetic fields can manipulate cells through two different methods: positive magnetophoresis and negative magnetophoresis. Positive magnetophoresis is a way of imparting magnetic properties to cells by labeling them with magnetic nanoparticles. Negative magnetophoresis is a label-free principle-based method. 3D cell structures, such as spheroids, 3D network structures, and cell sheets, have been successfully fabricated using this acoustic and magnetic stimuli-based 3D cell culture platform. Additionally, fabricated 3D cell structures showed enhanced cell behavior, such as differentiation potential and tissue regeneration. Therefore, physical stimuli-based 3D cell culture platforms could be promising tools for tissue engineering.
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Purpose@#The purpose of the study was to analyze the status of dietary behavior and nutrition intakes according to the gender and the level of physical activity of adolescents. @*Methods@#Data from 659 adolescents aged 13 to 18 years who participated in the Korea National Health and Nutrition Examination Survey (2017–2018) were analyzed. Collected data were analyzed using complex sampling data analysis with SPSS v. 27.0. @*Results@#The adolescents were categorized into three groups based on their physical activity as follows: The first group with high physical activity (8.9%), a second group with normal physical activity (29.7%), and a third group without physical activity (61.4%). Boys showed significantly higher physical activity than the girls. Adolescents with high physical activity had a significantly lower body mass index than adolescents without physical activity, but their meal regularity, subjective health status, and recognition of body image were significantly higher. In terms of biochemical factors, adolescents with high physical activity had lower triglycerides and cholesterol than adolescents without physical activity, while hemoglobin and hematocrit were significantly higher. In addition, the intakes of energy, carbohydrates, proteins, fat, vitamin B 1 , niacin, calcium, phosphorus, sodium, potassium, iron increased significantly as adolescents’ physical activity increased. @*Conclusion@#The physical activity of adolescents had a positive effect on dietary behavior, lifestyle, and nutritional factors. Therefore, it is necessary to increase participation in physical classes in schools and develop various programs considering the level of physical activity among adolescents.
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Background@#As the number of large-scale studies involving multiple organizations producing data has steadily increased, an integrated system for a common interoperable format is needed. In response to the coronavirus disease 2019 (COVID-19) pandemic, a number of global efforts are underway to develop vaccines and therapeutics. We are therefore observing an explosion in the proliferation of COVID-19 data, and interoperability is highly requested in multiple institutions participating simultaneously in COVID-19 pandemic research. @*Results@#In this study, a laboratory information management system (LIMS) approach has been adopted to systemically manage various COVID-19 non-clinical trial data, including mortality, clinical signs, body weight, body temperature, organ weights, viral titer (viral replication and viral RNA), and multiorgan histopathology, from multiple institutions based on a web interface. The main aim of the implemented system is to integrate, standardize, and organize data collected from laboratories in multiple institutes for COVID-19 non-clinical efficacy testings. Six animal biosafety level 3 institutions proved the feasibility of our system. Substantial benefits were shown by maximizing collaborative high-quality non-clinical research. @*Conclusions@#This LIMS platform can be used for future outbreaks, leading to accelerated medical product development through the systematic management of extensive data from non-clinical animal studies.
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Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and severe adverse drug reaction characterized by the cutaneous eruption, fever, eosinophilia, and involvement of internal organs. It is commonly caused by aromatic anticonvulsant drugs and antibiotics in children. In this study, we presented a case of a 9-year-old boy with bipolar disorder, who developed DRESS syndrome after lamotrigine intake for 10 days. Thereafter, lamotrigine was discontinued, and systemic corticosteroid treatment was pursued for 18 days. After 3 months, a patch test for lamotrigine was performed as a confirmatory test to check drug reaction. Reports of DRESS syndrome in adults have increased over the past decade due to the increasing use of lamotrigine as a new aromatic anticonvulsant. Although there are only a few lamotrigine-related DRESS syndrome reports in children, caution is needed with its potential widespread use in the future.
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Background@#People are generally considered overweight and obese if their body mass index (BMI) is above 25 kg/m 2 and 30.0 kg/m 2 , respectively. The World Health Organization proposed stricter criteria for Asians (≥ 23 kg/m2 : overweight, ≥ 25 kg/m2 : obese). We aimed to verify whether this criteria could predict adverse pregnancy outcomes in Korean women. @*Methods@#We included 7,547 Korean women from 12 institutions enrolled between June 2016 and October 2018. Women with no pre-pregnancy BMI data, not Korean, or lost to followup were excluded, leaving 6,331. The subjects were categorized into underweight, normal, overweight, class I obesity, and class II/III obesity based on a pre-pregnancy BMI of < 18.5, 18.5–22.9, 23.0–24.9, 25.0–29.9, and ≥ 30.0 kg/m2 , respectively. @*Results@#Overall, 13.4%, 63.0%, 11.8%, 9.1%, and 2.6% of women were underweight, normal, and overweight and had class I obesity and class II/III obesity, respectively. In the multivariable analysis adjusted for maternal age, a higher BMI significantly increased the risk of preeclampsia, gestational diabetes, preterm delivery caused by maternal-fetal indications, cesarean section, large for gestational age, and neonatal intensive care unit admission. @*Conclusion@#Adverse pregnancy outcomes started to increase in those with a pre-pregnancy BMI ≥ 23.0 kg/m2 after adjusting for maternal age. The modified obesity criteria could help predict adverse pregnancy outcomes in Koreans.
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Objective@#We investigated prenatal sonographic characteristics of esophageal atresia (EA) with advancing gestation. We focused on the degree of polyhydramnios and the stomach shape. @*Methods@#This study included 27 EA cases (EA group) and 81 idiopathic polyhydramnios cases (non-EA group). The non-EA group consisted of cases without any fetal structural anomaly, musculoskeletal disorder, chromosomal abnormality, or maternal diabetes. Both groups included only singleton pregnancies. Amniotic fluid index (AFI) and width/length (W/L) ratio as well as the product of width and length (W×L) of stomach were serially assessed during gestation and compared between the 2 groups. To predict EA using W/L ratio and W×L, receiver operating characteristic curve analysis was performed. @*Results@#Polyhydramnios was evident in 77.8% of EA cases. We observed 25.9% and 22.2% EA cases with an absent stomach and a small visible stomach, respectively. After 28 weeks, the EA group manifested significantly higher AFI than the non-EA group. After 32 weeks, W/L ratio in the EA group tended to be lower than that in the non-EA group (32–36 weeks: 1.36 vs. 1.72, P=0.092; >36 weeks: 1.43 vs. 1.63, P=0.024). To predict EA, the calculated area under the curve for W/L ratio was 0.651 after 32 weeks. The diagnosis of EA using a cut-off value of W/L ratio <1.376 showed sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio to be 84.6%, 52.9%, 1.796, and 0.081, respectively. @*Conclusion@#A low W/L ratio of stomach after 32 weeks with progressive idiopathic polyhydramnios may be used to predict EA.
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Purpose@#We report three cases of asymptomatic pseudo-optic discs in chorioretinal colobomas highlighted on visual fields patterns.Case summary: (Case 1) A 36-year-old man was found to have a pseudo-optic disc below the optic nerve with a relatively intact neurosensory retina over the lesion. There were no obvious abnormalities on the visual field test, so he underwent no treatment and was followed up every 6 months. (Case 2) A 37-year-old woman diagnosed with glaucoma had abrupt convergence of the neurosensory retinal layers on the boundary of the pseudo-optic disc and a focal retinal nerve fiber layer defect in the inferior sector. An antiglaucoma eyedrop was used to manage the superior hemifield defect, and no significant progression was observed in the structural and functional tests during the 5-year follow-up. (Case 3) A 57-year-old man had a pseudo-optic disc with diffuse retinal nerve fiber layer atrophy in both the superior and inferior sectors. The pseudo-optic disc had protruded into the vitreous cavity. Antiglaucoma eyedrops were used to manage both the superior and inferior hemifield defects, and no significant progression was observed using the structural and functional tests during the 6-year follow-up period. @*Conclusions@#Various visual field results may occur with pseudo-optic discs in chorioretinal colobomas depending on the status of residual retinal tissues and underlying glaucoma. Further evaluations and management options should be considered according to the patient’s condition.
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Although gravid uterine incarceration is typically diagnosed during the early second trimester, we encountered two unusual cases in early pregnancy. A 34-year-old multiparous woman with adenomyosis presented at 7 + 2 weeks of gestation with increased urinary frequency and a sensation of incomplete bladder emptying. The uterine incarceration was successfully reduced by manual reduction and pessary insertion, and she delivered a normal infant at term. In the second case, a 31-year-old nulliparous woman with a large myoma complained of dysuria, acute urinary retention, and intense back pain at 6 weeks of gestation. Manual reduction was successful in the knee-chest position. Subsequent pessary insertion failed; however, a slight reduction in pain was achieved. After a week, the fetus spontaneously aborted. In summary, gravid uterine incarceration is a rare but potentially fatal condition for the fetus, and a suspicion of this condition in patients with urinary symptoms, especially urinary retention and pelvic pain, is important in the early gestation period.
Sujets)
Adulte , Femelle , Humains , Nourrisson , Grossesse , Endométriose intra-utérine , Dorsalgie , Dysurie , Foetus , Position genupectorale , Myome , Douleur pelvienne , Pessaires , Deuxième trimestre de grossesse , Sensation , Vessie urinaire , Rétention d'urine , Maladies de l'utérus , UtérusRésumé
OBJECTIVE: To delineate cervical radiculopathy that is found in combination with traumatic cervical spinal cord injury (SCI) and to determine whether attendant cervical radiculopathy affects the prognosis and functional outcome for SCI patients. METHODS: A total of 66 patients diagnosed with traumatic cervical SCI were selected for neurological assessment (using the International Standards for the Neurological Classification of Spinal Cord Injury [ISNCSCI]) and functional evaluation (based on the Korean version Modified Barthel Index [K-MBI] and Functional Independence Measure [FIM]) at admission and upon discharge. All of the subjects received a preliminary electrophysiological assessment, according to which they were divided into two groups as follows: those with cervical radiculopathy (the SCI/Rad group) and those without (the SCI group). RESULTS: A total of 32 patients with cervical SCI (48.5%) had cervical radiculopathy. The initial ISNCSCI scores for sensory and motor, K-MBI, and total FIM did not significantly differ between the SCI group and the SCI/Rad group. However, at discharge, the ISNCSCI scores for motor, K-MBI, and FIM of the SCI/Rad group showed less improvement (5.44+/-8.08, 15.19+/-19.39 and 10.84+/-11.49, respectively) than those of the SCI group (10.76+/-9.86, 24.79+/-19.65 and 17.76+/-15.84, respectively) (p<0.05). In the SCI/Rad group, the number of involved levels of cervical radiculopathy was negatively correlated with the initial and follow-up motors score by ISNCSCI. CONCLUSION: Cervical radiculopathy is not rare in patients with traumatic cervical SCI, and it can impede neurological and functional improvement. Therefore, detection of combined cervical radiculopathy by electrophysiological assessment is essential for accurate prognosis of cervical SCI patients in the rehabilitation unit.
Sujets)
Humains , Classification , Électrophysiologie , Études de suivi , Évaluation des résultats des patients , Pronostic , Radiculopathie , Réadaptation , Traumatismes de la moelle épinièreRésumé
The purpose of the study was to examine nutritional management and nutritional care demands of home-visit care service and the nutritional status of serviced elderly. The survey was carried out from 5th to 21st of January, 2011 among 37 In-Home Service institutions. The number of elderly surveyed by 143 care helpers was 281. Analysis was performed for 203 subjects (male: 44, female: 159). The age distribution was from 50 to 99 years. The grading by long-term care insuranceshowed 18,2% on level 1 and 2, and 81.8% on level 3. For the disease treatment, the proportion of implementing diet treatment turned out to be very low. The proportion of subjects living with their children was 45.3%, and living alone was 29.1%. The proportion of home-visit care among types of In-Home Service was 70%. Subjects who needed additional necessary diet management service turned out to be 40.9%. Diet management was the most necessary services from all levels. MNA (specifiy MNA) scores were significantly (p < 0.001) associated with BMI, mid-arm circumference (MAC), calf circumference (CC), intake problems, and weight loss during the last 3 months. For studied elderly, 45.3% were malnourished, and 46.8% were at the risk of malnutrition by MNA score. Based on the result of this survey, the nutritional care was not systematic on the In-Home Service. Prevention and management of the disease was much better than the treatment to improve the quality of life. We conclude that nutrition management is necessary for the elderly. To improve nutritional status of elderly in home care services, systematic nutrition management should be implemented.