Risk of Severe Acute Respiratory Syndrome Coronavirus 2 Transmission in Seoul, Korea

BACKGROUND

The risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission during the endemic phase may vary from that during the previous pandemic phase. We evaluated the risk of infection in a general population with laboratory-confirmed coronavirus disease 2019 (COVID-19) in a community setting in Korea.

MATERIALS AND METHODS

This study included 1,286 individuals who had been in contact with an index COVID-19 case between January 24, 2020, and June 30, 2022. Variables such as age, sex, nationality, place of contact, level of contact, the status of exposed cases, period, and level of mask-wearing were assessed.

RESULTS

Among 1,286 participants, 132 (10.30%) were confirmed to have COVID-19. With increasing age, the risk of the exposed persons contracting COVID-19 from index cases tended to increase (P <0.001), especially for people in their 70s (odds ratio = 1.24, 95% confidence interval: 1.11 - 1.40, P <0.001). We found an increasing trend in the risk of a COVID-19 exposed case becoming a secondary infection case (P <0.001) in long-term care facilities where the attack rate was high.

CONCLUSION

The risk of COVID-19 transmission is high in long-term care facilities where many older adults reside. Intensive management of facilities at risk of infection and strict mask-wearing of confirmed COVID-19 cases are necessary to prevent the risk of COVID-19 infection.

Outbreak of carbapenem-resistant Enterobacterales at a long-term care facility in Seoul, Korea: surveillance and intervention mitigation strategies

OBJECTIVES

Because effective decolonization options are not available, and treatment options are limited, carbapenem-resistant Enterobacterales (CRE) constitute increasingly threatening nosocomial pathogens. To prevent CRE-associated transmission and ensure patient safety, healthcare personnel and everyone in contact with CRE-infected patients must implement stringent infection control practices. This report describes a CRE outbreak, possibly related to a caregiver at a long-term care facility (LTCF), and presents a new surveillance model to improve the infection control of CRE in Seoul, Korea.

METHODS

The Seoul Metropolitan Government surveillance system identified an outbreak of CRE in an LTCF in 2022. We obtained data on the demographic characteristics and contact histories of the inpatients, medical staff, and caregivers. To isolate the inpatients and employees exposed to CRE, we used rectal swab samples and environmental sampling during the study period (May-December 2022).

RESULTS

We identified 18 cluster cases (1 caregiver and 17 inpatients) and 12 sporadic cases with CRE, and conducted a complete 197-day follow-up of all cases in the LTCF's isolation wards.

CONCLUSIONS

This investigation demonstrated that our surveillance model and targeted intervention, based on the cooperation of the municipal government, public health center, and infection control advisory committee, effectively contained the epidemic at the LTCF. Measures to improve the compliance of all employees in LTCFs with infection control guidelines should also be adopted.

Transferrin-mediated increase of labile iron Pool following simulated ischemia causes lipid peroxidation during the early phase of reperfusion

Heart ischemia/reperfusion (I/R) injury is related to iron content. However, the occurrence and mechanism of changes in labile iron pool (LIP) during I/R is debatable. Moreover, the identity of the iron form dominant in LIP during I/R is unclear. Herein, we measured changes of LIP during simulated ischemia (SI) and reperfusion (SR), in which ischemia was simulated in vitro with lactic acidosis and hypoxia. Total LIP did not change in lactic acidosis, whereas LIP, especially Fe³⁺, increased in hypoxia. Under SI, accompanied by hypoxia with acidosis, both Fe²⁺ and Fe³⁺ were significantly increased. Increased total LIP was maintained at 1 h post-SR. However, the Fe²⁺ and Fe³⁺ portion was changed. The increased Fe²⁺ was decreased, and conversely the Fe³⁺ was increased. BODIPY oxidized signal increased and through the time-course these changes correlated with blebbing of cell membrane and SR-induced LDH release. These data suggested lipid peroxidation occurred via Fenton's reaction. The experiments using bafilomycin A1 and zinc protoporphyrin suggested no role of ferritinophagy or heme oxidation in the increase of LIP during SI. The extracellular source, transferrin assessed using serum transferrin bound iron (TBI) saturation showed that the depletion of TBI reduced SR-induced cell damages and additive saturation of TBI accelerated SR-induced lipid peroxidation. Furthermore, Apo-Tf dramatically blocked the increase of LIP and SR-induced damages. In conclusion, Tf-mediated iron induces the increase of LIP during SI, and it causes Fenton reaction-mediated lipid peroxidation during the early phase of SR.

The optimal model of reperfusion injury in vitro using H9c2 transformed cardiac myoblasts

An in vitro model for ischemia/reperfusion injury has not been well-established. We hypothesized that this failure may be caused by serum deprivation, the use of glutamine-containing media, and absence of acidosis. Cell viability of H9c2 cells was significantly decreased by serum deprivation. In this condition, reperfusion damage was not observed even after simulating severe ischemia. However, when cells were cultured under 10% dialyzed FBS, cell viability was less affected compared to cells cultured under serum deprivation and reperfusion damage was observed after hypoxia for 24 h. Reperfusion damage after glucose or glutamine deprivation under hypoxia was not significantly different from that after hypoxia only. However, with both glucose and glutamine deprivation, reperfusion damage was significantly increased. After hypoxia with lactic acidosis, reperfusion damage was comparable with that after hypoxia with glucose and glutamine deprivation. Although high-passage H9c2 cells were more resistant to reperfusion damage than low-passage cells, reperfusion damage was observed especially after hypoxia and acidosis with glucose and glutamine deprivation. Cell death induced by reperfusion after hypoxia with acidosis was not prevented by apoptosis, autophagy, or necroptosis inhibitors, but significantly decreased by ferrostatin-1, a ferroptosis inhibitor, and deferoxamine, an iron chelator. These data suggested that in our SIR model, cell death due to reperfusion injury is likely to occur via ferroptosis, which is related with ischemia/reperfusion-induced cell death in vivo. In conclusion, we established an optimal reperfusion injury model, in which ferroptotic cell death occurred by hypoxia and acidosis with or without glucose/glutamine deprivation under 10% dialyzed FBS.

Role of Google Glass in improving patient satisfaction for otolaryngology residents: a pilot study

OBJECTIVES

To demonstrate the feasibility and efficacy of the Google Glass as a tool to improve patient satisfaction and patient-physician communication for otolaryngology residents in the outpatient clinic setting. The primary outcome of the study was to improve patient satisfaction scores based on physician communication-related questions from Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys.

STUDY DESIGN

Prospective randomised trial.

SETTING

Tertiary care hospital.

SUBJECT AND METHODS

To evaluate the effect on patient satisfaction, five residents were recorded using the Google Glass in an outpatient clinic setting by 50 randomised patients. Modified surveys based on the CG-CAHPS survey were completed by patients at the conclusion of each clinic encounter. The recorded videos were evaluated by two independent faculties. Summarised data and video were distributed to each resident for review as the intervention. The residents were recorded again by 45 additional patients with evaluation by patients and faculties.

RESULTS

After intervention, the scores from faculty surveys regarding patient satisfaction including the subject of better explanations (P > 0.001), listening carefully (P > 0.001), addressing patient questions (P > 0.001), displaying respect (P > 0.001) and spending adequate time (P = 0.0005) all significantly improved, as well as overall performance (P = 0.014). The scores from patient surveys did significantly improve.

CONCLUSION

This study demonstrates the improvements in patient satisfaction and patient-physician communication can be achieved with the use of Google Glass as a first-person recording device in the outpatient otolaryngology clinic setting.

Functional severity and Latino ethnicity in specialty services for children with autism spectrum disorder

BACKGROUND

Children with autism spectrum disorder (ASD) experience a range of severity levels characterised as levels of support they need for everyday functioning. By this definition, greater levels of severity should warrant greater use of services and supports among children with ASD. In previous studies, Latino children with ASD in the USA have been shown to have lower access to diagnosis and treatment services than White children. However, none have examined service use in relation to severity. In this study, we examined whether there are ethnic disparities between Latino and White children with ASD in specialty autism-related services, and whether functional severity moderates the relationship between ethnicity and receipt of autism services.

METHODS

We used data from the Survey of Pathways to Diagnosis and Services, a supplement to the National Survey of Children with Special Health Care Needs and analysed four specialty services commonly used by children with ASD, adjusting for demographic variables.

RESULTS

We found that Latino children with ASD who had severe limitations received fewer specialty autism-related services than White children with similarly severe conditions. These disparities were evident despite the fact that the sample of Latino children in these data were more privileged than the general US Latino population.

CONCLUSION

Assertive policy initiatives are needed to address these disparities and ensure that these highly vulnerable children with severe functional limitations receive appropriate services and supports.

Test of an intervention to improve knowledge of women with intellectual disabilities about cervical and breast cancer screening

BACKGROUND

There is a critical need for evidence-based health education interventions for women with intellectual disabilities (IDs) to promote receipt of preventive health screenings. Previous research has established Women Be Healthy, an 8-week classroom-style intervention designed to teach women with IDs about breast and cervical cancer screenings, as a promising practice. However, additional research is needed to determine how to further improve screening-related knowledge gains. This study aimed to test a modified version of Women Be Healthy, Women Be Healthy 2, and compare its effectiveness in increasing knowledge gains to the original intervention.

METHOD

Women living in the community across one state in the United States were randomly assigned to a treatment (n = 98), delayed treatment, (n = 35), or no intervention group (n = 65). Women in the treatment group received Women Be Healthy, and women in the delayed treatment group received the modified Women Be Healthy 2. Baseline and post-intervention interviews were conducted to measure knowledge of cervical and breast cancer screening. Knowledge scores were compared across groups.

RESULTS

Among the nine knowledge items measured, one breast knowledge measure and one cervical knowledge measure showed statistically significant group differences; marginally significant differences were observed for two other knowledge measures. After adjusting for covariates, women who received Women Be Healthy 2 had increased knowledge overall compared with the women receiving no intervention.

CONCLUSION

Women Be Healthy 2 is promising, but additional efforts appear necessary to increase the knowledge women with IDs have about cervical and breast cancer screening.

Diversity and decay ability of basidiomycetes isolated from lodgepole pines killed by the mountain pine beetle

When lodgepole pines ( Pinus contorta Douglas ex Louden var. latifolia Engelm. ex S. Watson) that are killed by the mountain pine beetle ( Dendroctonus ponderosae ) and its fungal associates are not harvested, fungal decay can affect wood and fibre properties. Ophiostomatoids stain sapwood but do not affect the structural properties of wood. In contrast, white or brown decay basidiomycetes degrade wood. We isolated both staining and decay fungi from 300 lodgepole pine trees killed by mountain pine beetle at green, red, and grey stages at 10 sites across British Columbia. We retained 224 basidiomycete isolates that we classified into 34 species using morphological and physiological characteristics and rDNA large subunit sequences. The number of basidiomycete species varied from 4 to 14 species per site. We assessed the ability of these fungi to degrade both pine sapwood and heartwood using the soil jar decay test. The highest wood mass losses for both sapwood and heartwood were measured for the brown rot species Fomitopsis pinicola and the white rot Metulodontia and Ganoderma species. The sap rot species Trichaptum abietinum was more damaging for sapwood than for heartwood. A number of species caused more than 50% wood mass losses after 12 weeks at room temperature, suggesting that beetle-killed trees can rapidly lose market value due to degradation of wood structural components.

Sentinel Lymph Node Biopsy in Patients Who Have Negative Conversion of Axillary Lymph Node after Neoadjuvant Chemotherapy for Node Positive Breast Cancer

Background: Sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NAC) has been currently debatable. It is possible that the tumor response to chemotherapy may alter the lymphatic drainage thus causing lower SLN identification rate and higher false negative rate. Further, the response of NAC can be different in each lymph nodes. It is doubtful whether SLNB can accurately predict axillary lymph node (ALN) status after NAC. The aim of this study to determine the identification rate, the false-negative rate, and the accuracy of SLNB after NAC for node positive breast cancer.Patients and Methods: A prospective study was initiated to evaluate the results of SLNB after NAC. From January 2007 to April 2009, 81 patients with positive axillary lymph nodes enrolled from two institutions after IRB-approved. They received NAC and then evaluated negative conversion of metastatic lymph node with both PET and breast US. All of them underwent ALN dissection after SLNB with subareolar intradermal injection technique using radioisotope. We evaluated the identification rate, false negative rate, accuracy of SLNB according to the response of chemotherapy in axillary lymph nodes (negative conversion group or remaining positive group).Results: Before the NAC, 31 patients had multiple axillary lymph node metastasis and 50 patients had single metastasis. After NAC 44 cases (54.3%) turned into negative node and 37 cases (45.7%) remained positive nodes. Total identification rate was 80.2% (65 of 81), false negative rate was 19.0% (8 of 42) and accuracy was 87.7% (57 of 65). In negative conversion group showed 84.1% (37 of 44) of identification rate, 21.1% (4 of 19) of false negative rate, 89.2% (33 of 37) of accuracy. In remaining positive group revealed 75.7% (28 of 37) of identification rate, 17.4% (4 of 23) of false negative rate, 85.7% (24/28) of accuracy. There was no statistical significant difference of identification rate, false negative rate, accuracy of SLNB among the two group after NAC (p=0.343, p=0.534, p=0.478, respectively).Conclusion: This study showed relatively low detection rate and accuracy, high false-negative rate of SLNB, even if the positive nodes changed to negative node after NAC. Thus sentinel lymph node biopsy after NAC for node positive breast cancer should be cautious. Since this study had small number of negative conversion patients, further larger prospective studies are required for more proper conclusion.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1022.

Electrochemical behavior and differential pulse polarographic determination of piperacillin sodium

In an aqueous piperacillin sodium solution, a well-defined single wave or single peak was observed by direct current (DC) polarography or differential pulse polarography (DPP). The peak potential change per pH unit was -54 mV in the phosphate buffer at 18 degrees C, which indicated that protons were involved in the electrochemical reduction of the 2,3-dioxopiperazine moiety of piperacillin sodium with a H+/e- ratio of one. Using a phosphate buffer of pH 4.3, the 1.0 x 10(-7) M piperacillin sodium single peak could be determined by DPP with relative standard deviation of 1.6% (n=3). Piperacillin sodium could be analyzed without interference from penicillin G-potassium, which enabled the employment of DPP as a fast and simple technique for monitoring the synthetic process of the antibiotic.

Importance of microperineural invasion as a prognostic factor in ampullary carcinoma

BACKGROUND

This was a study of the relation of clinicopathological factors to prognosis in 25 patients who had ampullary carcinoma resected.

METHODS

The 5-year survival rate was six of the 25 patients. The presence of microperineural invasion was sought and related to outcome.

RESULTS

Factors relating to prognosis included tumour gross appearance, diameter, pancreatic invasion and microperineural invasion. The 5-year survival rate of 14 patients with microperineural invasion was 3, significantly worse than the 7 in 11 without invasion (P = 0.002, univariate analysis). By multivariate analysis, microperineural invasion was the most important prognostic factor (P = 0.02). Type of tumour recurrence was similar to that in pancreatic carcinoma.

CONCLUSION

Pancreaticoduodenectomy, rather than local resection, is the procedure of choice in patients with ampullary carcinoma.

Importance of microperineural invasion as a prognostic factor in ampullary carcinoma

BACKGROUND

This was a study of the relation of clinicopathological factors to prognosis in 25 patients who had ampullary carcinoma resected.

METHODS

The 5-year survival rate was six of the 25 patients. The presence of microperineural invasion was sought and related to outcome.

RESULTS

Factors relating to prognosis included tumour gross appearance, diameter, pancreatic invasion and microperineural invasion. The 5-year survival rate of 14 patients with microperineural invasion was 3, significantly worse than the 7 in 11 without invasion (P = 0.002, univariate analysis). By multivariate analysis, microperineural invasion was the most important prognostic factor (P = 0.02). Type of tumour recurrence was similar to that in pancreatic carcinoma.

CONCLUSION

Pancreaticoduodenectomy, rather than local resection, is the procedure of choice in patients with ampullary carcinoma.

Adjuvant hepatic arterial IL-2 and MMC, 5-FU after curative resection of colorectal liver metastases

BACKGROUND/AIMS

Based on our favorable results of interleukin-2-based immuno-chemotherapy in the treatment of unresectable liver metastases from colorectal cancer, we utilized this therapy for the prevention of liver recurrence after liver resection.

MATERIALS AND METHODS

Eighteen patients with colon cancer metastatic to the liver underwent successful hepatic resection and adjuvant immunochemotherapy that included hepatic arterial infusion of interleukin-2 and mitomycin C, 5-fluorouracil. The regimen consisted of weekly interleukin-2 (1.4-2x 10(6) units), 5-fluorouracil (250 mg) by 2-hour infusion and bolus mitomycin C (4 mg) for 6 months.

RESULTS

Fourteen of 18 patients are alive and disease-free with a median postoperative follow-up of 28.5 months. Recurrent cancer has developed in 4 of the 18 patients (22%). The site of first recurrence was the lung in three patients (17%) and the pelvis in one (6%); no patients recurred in the liver.

CONCLUSIONS

We recommend this adjuvant immuno-chemotherapy for the prevention of liver recurrence after curative resection of colorectal liver metastases.