Molecular Prevalence and Genotypes of Cryptosporidium parvum and Giardia duodenalis in Patients with Acute Diarrhea in Korea, 2013-2016

Da-Won Ma,이명노,Sung-Hee Hong,조신형,Sang-Eun Lee 대한기생충학ㆍ열대의학회 2019 The Korean Journal of Parasitology Vol.57 No.5

Cryptosporidium parvum and Giardia duodenalis are the main diarrhea-causing parasitic pathogens; however, their prevalence in Korea is unknown. Here, we conducted a survey to determine the prevalence and genotype distribution of these 2 pathogens causing acute diarrhea in 8,571 patients hospitalized in 17 Regional Institute of Health Environment sites in Korea, during 2013-2016. C. parvum and G. duodenalis were detected and genotyped by nested PCR, and the isolate were molecularly characterized by sequencing the glycoprotein 60 (Gp60) and β-giardin genes, respectively. The overall prevalence of C. parvum and G. duodenalis was 0.37% (n=32) and 0.55% (n=47), respectively, and both pathogens were more prevalent in children under 9 years old. Molecular epidemiological analysis showed that the C. parvum isolates belonged to the IIa family and were subtyped as IIaA13G2R1, IIaA14G2R1, IIaA15G2R1, and IIaA18G3R1. Analysis of the β-giardin gene fragment from G. duodenalis showed that all positive strains belong to assemblage A. This is the first report on the molecular epidemiology and subtyping of C. parvum and G. duodenalis in such a large number of diarrheal patients in Korea. These results highlight the need for continuous monitoring of these zoonotic pathogens and provide a basis for implementing control and prevention strategies. Further, the results might be useful for epidemiological investigation of the source of outbreak.

양수내 Creatinine치에 관한 연구

김영석(YS Kim),민병철(BC Min),이명아(MA Lee),박창서(CS Park),박찬용(CY Park),조성진(SJ Cho) 대한산부인과학회 1988 Obstetrics & Gynecology Science Vol.31 No.10

정확한 태아 성숙도 판정을 위해서 임신 제 35주에서 제 41주까지의 정상임부 35례, 자간전 증을 합병한 임부 28예에서 양수와 모체혈청의 creatinine concentration측정 및 shake test를 동시에 실시하였다. 그리고 전례에서 호흡장해증후군의 발생을 관찰하여 위의 검사결과에 입각한 태아 성숙도 판정을 시도하여 다음과 같은 결론은 얻었다. 1. 양수내 creatinine concentration 및 AF/MS비는 정상임신군 및 자간전증군에서 임신주수에 따라 점차로 증가하였다. 2. 자간전증군의 양수와 모체혈청 creatinine concentration 및 평균 AF/MS비는 정상임신군의 수치보다 유의하게 높았다. 3. 태아 성숙기준을 임신 제 37주이상으로 정하였고 양수 creatinine concentration 2.0mg%이 상, AF/MS비 2.5이상 그리고 positive shake test를 성숙기준으로 선택할 때 ,그 정확도는 정 상임신군에서는 85.7%, 82.9% 88.9%이었고, 자간전증군에서는 89.3% 95.7% 92.9% 이었다. 그리고태아체중 2500g을 성숙기준으로 하고 똑같은 방법으로 예측한 태아 성숙판정의 정확 도는 정상임신군에서는 88.6% 91.4% 85.7% 이엇고, 자간전증군에서는 75.0% 78.6% 75.0%ㅇ 었다. 4. 총 7예의 신생아에서 신생아 호흡장해증후군이 발생했는데 4례는 정상임신군에서 3례는 자간전증군에서였다. Accurate estimation of fetal maturity is neccessary where termination of pregnancy before term is indicated. To predict the fetal maturity creatine concentration of amniotic fluid and maternal serum were measured and shake test was performed simultaneously in the 35 normal pregnancy women and 28 preeclamptic women between 35 to 41 gestational weeks. The results were as follows; 1. The creatinine concentration of amniotic fluid and aminiotic fluid/maternal serum concentration of creatinine (AF/MS) ratio increased gradually related to gestational weeks in normal and preeclamptic pregnancy. 2. The mean amniotic fluid and maternal serum creatinine concentration and the mean AF/MS ratio in preeclamptic pregnancy were significantly higher than those inf the the normal pregnancy. 3. Assuming a creatinine concentration 2.0mg% or greater in the amniotic fluid, AF/MS ratio of 2.5 or greater and positive shake test to corespond with 37 weeks of gestational age, the accuracy in predicting fetal maturity was 85.7%, 82.9% and 88.9% in normal pregnancy and 89.3% , 95.7% and 92.9% in preeclamptic pregnancy, respectively. Assuming same indication to correspond with 2500 mg of fetal weight , the accuracy in predicting fetal maturity was 88.6%, 91.4% and 85.7% in normal pregnancy and 75%, 78.6% and 75% in preeclamptic pregnancy, respectively. 4. Total 7 neonates developed respiratory distress syndrome, four in normal group and remainder in preeclamptic pregnancy group.

뇨실금을 동반하거나 하지않은 자궁탈에 대한 질식자궁적출술과 전질벽협축술의 임상적 및 요로 역학적 효과

유지헌(JH Yoo),오세창(SC Oh),이명아(MA Lee),박찬용(CY Park),조성진(SJ Cho),박인서(IS Park) 대한산부인과학회 1987 Obstetrics & Gynecology Science Vol.30 No.4

1983년 3월부터 1985년 2월까지 만 2년간 국립의료원 산부인과에 입원하여 질식자궁적출술 및 질벽협축술을 시행한 27명의 자궁질탈출증 환자에서 다음과 같은 결론을 얻었다 1 환자의 평균연령은 55 1세로 모두 경산부이었다 긴장성 뇨실금을 동반한 예는 21례로 77 8%이었으며, 분만횟수가 증가함에 따라 자궁질탈출증 및 뇨실금의 빈도는 증가하였다 2 수술후 뇨실금, 빈뇨, 배란곤란, 급뇨 등의 요로증상은 현저히 호전되었으며, 수술후 뇨실금이 1예 발생하였는데 이는 배뇨근 부전증에 의한 것이었다 3 수술후 합병증은 질개구탈출술, 배뇨근 부전중, 질방광루, 신우신염 각 1예씩 있었으며, 그 빈도는 14 8%이었다 4 방광내압검사상 뇨실금군 및 뇨실금을 동반하지 않은 군 모두에서 유의한 차이는 없었다 5 복압을 가하였을 경우 방광기저부 및 PUV junction의 하강도는 수술후 양군 모두에서 감소하였으나, 유의한 차이는 없었고, 증상소실군과 지속군 사이에도 하강도의 유의한 차이는 없었다 6 수술후 복압을 가하였을 경우 angle of inclination의 변화는 뇨실금군에서 현저히 감소 하였으며, 증상소실군과 지속군 사이에는 유의한 차이가 없었다 7 수술후 PUV angle의 변화는 뇨실금 유 무에 관계없이 공히 감소하였으며, 증상소실군과 지속군 사이에 유의한 차이를 보였다 위와 같은 결론으로 첫째, 방광내압검사는 뇨속도검사(uroflowmetry)와 함께 시행하지 않았기 때문에 의의있는 정보는 얻을 수 없었으나, 배뇨근 부전증 및 신경성 방광을 감별하는데 도움이 되었고, 둘째, Chain을 이용한 방광뇨도촬영술은 비디오 방광뇨도 촬영술과 같은 특수검사시설이 없는 경우에 PUV angle의 변화정도를 관찰하기 위하여 시행하여 볼 만한 가치가 있었다 Clinical and urodynamic studies were made on 27 cases of uterine prolapse with or without incontinence after vaginal hysterectomy and anterior colporrhapy at the Department of Obstetrics and Gynecology, National Medical Center from March 1, 1983 to February 28, 1985 The results obtained were as follows; 1 All patient were multiparous women whose mean age was 55 1 year The incidence of urinary incontinence associated with uterine prolapse was 77 8%, which tended to be increasing according to the number of parity and age 2 Urinary symptoms such as stress incontinence, frequency, voiding difficulty and urgency were markedly improved after operation Urinary incontinence newly developed in one case due to detrusor instability 3 The overall incidence of postoperative complication was 14 8% Complications induced each one case oe vaginal vault prolapse, detrusor instability, vesicovaginal fistula and pyelonephritis respectively 4 Preoperative and postoperative cystometry showed no significant difference in either with or without urinary incontinence 5 On straining, symptom improved group showed more decrease in the descended length of the bladder base and posterior urethrovesical junction than the symptom continued group, but there was no statistical significance between each group 6 On straining, the postoperative change in the inclination angle was prominently noted in incontinent group than in continent one But no significant difference was found between symptom improved and continued group 7 Significant difference in the decrease in posterior urethrovesical angle between incontinent and continent group, which also significantly decreased in both symptom improved group and continued group

자궁내 피임장치와 동반된 골반 방선균증 1 예

허택(T Hur),양남훈(NH Yang),김동석(DS Kim),이명아(MA Lee),조성진(SJ Cho) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.9

Actinomycosis is a slowly progressive infection due to an anaerobic gram-positive bacterium. Actinomycotic infection of the female genital tract are rare. The presence of a long-standing intrauterine contraceptive device (IUD) is a well-known risk factor in young women. The diagnosis is frequently missed preoperatively. Actinomyces infection should be born in mind in the differential diagnosis of a young female with an IUD, fever, and abdominal mass. All patients with IUDs should undergo annual cytologic smears. We have experenced a case of pelvic actinomycosis associated with IUD and report this case with a brief review of literatures.

항 Cardiolipin 항체와 임신에 대한 연구

한기정(KJ Han),주관영(KY Joo),배덕호(DH Bae),이명아(MA Lee),조성진(SJ Cho),박인서(IS Park) 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.6

Currently, there are some reports concerning adverse pregnancy outcome complicated by anticardiolipin antibody. This study sought to determine the correlation with pregnancy outcome in 62 complicated pregnancies of third trimester of gestation. Result were compared with 60 normal pregnancies of third trimester. Sixty-two complicated pregnancy were classified by 52 present complicated pregnancies, 5 previous and 5 previous with present complicated pregnancies. Complicated pregnancies were combined with spontaneous abortion, more than two, fetal death in uterus after 20 weeks of gestation (FDIU), fetal growth retardation in uterus(IUGR), preterm labor, pregnancy induced hypertension, abruptio placenta and placenta previa. Anticardiolipin antibody was detected by enzyme-linked immunosorbent assay (ELISA). Mean level of anticardiolipin antibody was 0.177 in normal pregnancies, 0.127 in previous complicated pregnancies and 0.186 in previous with present complicated pregnancies. Level of anticardiolipin antibody was not statistically correlated with previous and previous with present compliated pregnancies. In present complicated pregnancies, mean level of anticardiolipin antibody was 0.146, which was statistically significant association with present complication, especially preterm labor and fetal growth retardation in uterus. On the basis of the above data, we concluded that there is a statistically significant association between level of anticardiolipin antibody and the present complication, especially preterm labor and IUGR. But it is controversal that anticardiolipin antibody seems to be predictive value of complicated pregnancy.

가족성 팔목터널 증후군 1가족례

이명종,김광국,이상암,마효일,윤준오 울산대학교 의과대학 1993 울산의대학술지 Vol.2 No.1

This is a report of familial carpal tunnel syndrome(CTS) occuring in four members of two generations of a Korean family. One of those with CTS had surgical release and its pathologic finding was nonspecific fibrotic change. The age of those affected by CTS ranged form 35 to 76 years of age. Family pedigree suggests an autosomal dominant gene. This is belived to be the first case report of familial carpal tunnel syndrome in Korea.

중증근무력증을 동반한 흉선외 악성림프종 1례

김성용,이명아,우인숙,강진형,홍영선,이경식 大韓血液學會 2003 大韓血液學會誌 Vol.38 No.3

파킨슨병 환자의 순목반사 : 반복자극에 의한 습관화의 감소

최일순,이상암,마효일,임주혁,이명종 대한신경과학회 1997 대한신경과학회지 Vol.15 No.4

자궁외임신시 혈청 beta-HCG , Progesterone 및 SP1에 관한 연구

조성진,박찬용,박창서,이명아,노은배,한지현 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.12

자궁외임신의 진단을 위한 혈중 SP1의 진단적 의의를 평가하기 위해 정상임신 49예와 자궁외임신 24예를 대상으로 임신 제 5주에서 제 11주의 SP1, -HCG, progesterone치를 이중항체 방사면역측정법으로 측정하여 비교연구 함으로써 다음과 같은 결과를 얻었다. 1. 정상임신군의 연령분포는 20세에서 44세까지로 평균 32.3세이었고, 자궁외 임신군에서는 20세에서 30세까지로 평균 27.6세이었다. 2. 혈중 -HCG측정치(평균치±2표준편차)는 정상임신에서는 임신 제 5주에서 28,741±19,080mIU/ml이었고, 임신이 진행됨에 따라 점차 증가하여 제 10주에 159,185±54,884mIU/ml이었으나, 제 11주에서는 114,068±83,072mIU/ml로 감소하는 양상을 보였다. 그러나 자궁외임신에 있어 혈청 -HCG측정치는 무월경 제 5주에 5,354±3,204mIU/ml, 제 9주에 11,124±7,450mIU/ml로 정상임신에 비해 낮은 수치를 보였다. 3. 혈청 progesterone측정치는 정상임신에 있어 임신 제 5주에 47.96±38.62ng/ml, 임신 제 8주에 48.59±29.12ng/ml로 별다른 증가 양상은 없었고, 제 9주부터는 증가하여 제 11주에 102.76±31.60이었다. 자궁외임신시 혈청 progesterone치는 무월경 제 5주에 22.99±10.52ng/ml, 제 9주에 16.96±1.94ng/ml로 정상임신군보다 낮은 수치를 보였다. 4. SP1도 임신 제 5주에는 0.4±0.24mg/l이었고, 점차 증가하여 제 10주는 8.7±4.80mg/l이었다. 그러나 자궁외임신에 있어서 무월경 제 5주에는 0.033±0.012mh/l, 제 9주에는 0.692±0.210mg/l로 재태기간에 따라 증가하나 정상범위 미만이었다. 5. 혈청 -HCG, progesterone 및 SP1의 예측치는 각각 73.1%, 80.0%, 80.8%이었고, 예민도는 79.2%, 83.3%, 87.5%였으며, 정확도는 85.7%, 89.8%, 89.8%이었다. The ectopic pregnancy has recently become one of the most important issues in obstetrics. The development of diagnostic method, such as, untrasonogram, serial serum beta-HCG measurement has made a great contribution to the treatment of ectopic pregnancies. In order to investigate the various hormonal factors of ectopic pregnancy and contribute to prevention of infertility thereafter, retrospective studies were made on serum beta-HCG, progesterone, and SPI values of 24 cases of ectopic pregnancy, which was diagnosed by biopsy of surgical specimen. The results were obtained as follows. 1. The age in normal pregnancy were ranged from 20 to 44 years and mean age was 32.3 years, but the age in ectopic pregnancy were ranged from 20 to 40 years and mean age was 27.6years. 2. Serum beta-HCG values(mean ±2SD) in normal pregnancy were 24,741±19,080mIU/ml, 159,185±54,884mIU/ml at 5th and 10th weeks of gestational age. But in ectopic pregnancy, 5,354±3,204mIU/ml, 11,124±7,450mIU/ml at 5th and 9th weeks of gestational age. 3. Serum progesterone values in normal pregnancy were 47.96±38.62ng/ml, 97.83±12.62ng/ml at 5th and 10th weeks of gestational age. But in ectopic pregnancy, 22.99±10.52ng/ml and 16.96±1.94ng/ml at 5th and 9th weeks of gestational age. 4. Serum SP1 values in normal pregnancy were 0.4±0.24mg/1,8.7±4.80mg/1 at 5th and 10th weeks of gestational age. But in ectopic pregnancy, 0.033±0.012mg/1, 0.692±0.210mg/1 at 5th and 9th weeks of gestational age. 5. Predictive value, sensitivity, and specificity of serum beta-HCG in ectopic pregnancy were 73.1%, 79.2% and 85.7%. 6. Predictive value, sensitivity, and specificity of progesterone in ectopic pregnancy were 80.0%, 83.3% and 89.8%, respectively. 7. Predictiv value, sensitivity, and specificity of serum SPI were 80.0%, 87.5% and 89.8%, respectively.