Enteric Bacteria Isolated from Diarrheal Patients in Korea in 2014

Objectives

The aim of this study was to characterize the pathogens responsible for causing diarrhea according to season, region of isolation, patient age, and sex as well as to provide useful data for the prevention of diarrheal disease.

Methods

Stool specimens from 14,886 patients with diarrhea were collected to identify pathogenic bacteria from January 2014 to December 2014 in Korea. A total of 3,526 pathogenic bacteria were isolated and analyzed according to season, region of isolation, and the age and sex of the patient.

Results

The breakdown of the isolated pathogenic bacteria were as follows: Salmonella spp. 476 (13.5%), pathogenic Escherichia coli 777 (22.0%), Vibrio parahaemolyticus 26 (0.74%), Shigella spp. 13 (0.37%), Campylobacter spp. 215 (6.10%), Clostridium perfringens 508 (14.4%), Staphylococcus aureus 1,144 (32.4%), Bacillus cereus 356 (10.1%), Listeria monocytogenes 1 (0.03%), and Yersinia enterocolitica 10 (0.3%). The isolation rate trend showed the highest ratio in the summer season from June to September for most of the pathogenic bacteria except the Gram-positive bacteria. The isolation rate of most of the pathogenic bacteria by patient age showed highest ratio in the 0–19 year age range. For isolation rate by region, 56.2% were isolated from cities and 43.8% were isolated from provinces.

Conclusion

Hygiene education should be addressed for diarrheal disease-susceptible groups, such as those younger than 10 years, aged 10–19 years, and older than 70 years, and monitoring for the pathogens is still required. In addition, an efficient laboratory surveillance system for infection control should be continued.     

Methotrexate use does not increase the prevalence of hepatic steatosis: a real-world retrospective nested case-control study

Clinical Rheumatology - We aimed to determine whether methotrexate (MTX) treatment in patients with rheumatoid arthritis (RA) leads to the development of non-alcoholic fatty liver (NAFL). Data were...     

Expressional analysis of anti-apoptotic phospho-BAD protein and mutational analysis of pro-apoptotic BAD gene in hepatocellular carcinomas

BACKGROUND: It has become clear that, together with proliferation, deregulation of apoptosis plays a pivotal role in tumourigenesis. BAD is a pro-apoptotic Bcl-2 family protein and regulates the intrinsic apoptosis pathway. Phosphorylation of BAD inhibits the apoptosis function of BAD. AIMS: To investigate whether alteration of the phospho-BAD protein and somatic mutation of BAD gene are characteristics of human hepatocellular carcinoma. PATIENTS AND METHODS: We analysed the expression of phospho-BAD in 20 hepatocellular carcinomas by immunohistochemistry. Also, we analysed the BAD gene for the detection of somatic mutations by a single-strand conformation polymorphism assay in 69 hepatocellular carcinomas. RESULTS: Phospho-BAD expression in the non-tumour hepatocytes was seen in all of the hepatocellular carcinomas, while the expression in the cancer cells was observed in 15% (3 of the 20) of the hepatocellular carcinomas. There was no somatic mutation of BAD Bcl-2 homology 3 (BH3) domain in the 69 hepatocellular carcinomas. CONCLUSIONS: The data showed that loss of phospho-BAD expression, but not BAD gene mutation, is a feature of hepatocellular carcinomas. The decreased expression of phospho-BAD in the hepatocellular carcinoma cells compared to the non-tumour hepatocytes suggests that loss of phospho-BAD expression may play a role in hepatocellular tumourigenesis.     

Mortality prediction of rats in acute hemorrhagic shock using machine learning techniques

This study sought to determine a mortality prediction model that could be used for triage in the setting of acute hemorrhage from trauma. To achieve this aim, various machine learning techniques were applied using the rat model in acute hemorrhage. Thirty-six anesthetized rats were randomized into three groups according to the volume of controlled blood loss. Measurements included heart rate (HR), systolic and diastolic blood pressures (SBP and DBP), mean arterial pressure, pulse pressure, respiratory rate, temperature, blood lactate concentration (LC), peripheral perfusion (PP), shock index (SI, SI = HR/SBP), and a new hemorrhage-induced severity index (NI, NI = LC/PP). NI was suggested as one of the good candidates for mortality prediction variable in our previous study. We constructed mortality prediction models with logistic regression (LR), artificial neural networks (ANN), random forest (RF), and support vector machines (SVM) with variable selection. The SVM model showed better sensitivity (1.000) and area under curve (0.972) than the LR, ANN, and RF models for mortality prediction. The important variables selected by the SVM were NI and LC. The SVM model may be very helpful to first responders who need to make accurate triage decisions and rapidly treat hemorrhagic patients in cases of trauma.     

Additional Value of Integrated 18F-FDG PET/MRI for Evaluating Biliary Tract Cancer: Comparison with Contrast-Enhanced CT

ObjectiveTo evaluate the value of ¹⁸F-fluorodeoxyglucose PET/MRI added to contrast-enhanced CT (CECT) in initial staging, assessment of resectability, and postoperative follow-up of biliary tract cancer.Materials and MethodsThis retrospective study included 100 patients (initial workup [n = 65] and postoperative follow-up [n = 35]) who had undergone PET/MRI and CECT for bile duct or gallbladder lesions between January 2013 and March 2020. Two radiologists independently reviewed the CECT imaging set and CECT plus PET/MRI set to determine the likelihood of malignancy, local and overall resectability, and distant metastasis in the initial workup group, and local recurrence and distant metastasis in the follow-up group. Diagnostic performances of the two imaging sets were compared using clinical-surgical-pathologic findings as standards of reference.ResultsThe diagnostic performance of CECT significantly improved after the addition of PET/MRI for liver metastasis (area under the receiver operating characteristic curve [A_z]: 0.77 vs. 0.91 [p = 0.027] for reviewer 1; 0.76 vs. 0.92 [p = 0.021] for reviewer 2), lymph node metastasis (0.73 vs. 0.92 [p = 0.004]; 0.81 vs. 0.92 [p = 0.023]), and overall resectability (0.79 vs. 0.92 [p = 0.007]; 0.82 vs. 0.94 [p = 0.021]) in the initial workup group. In the follow-up group, the diagnostic performance of CECT plus PET/MRI was significantly higher than that of CECT imaging for local recurrence (0.81 vs. 1.00 [p = 0.029]; 0.82 vs. 0.94 [p = 0.045]).ConclusionPET/MRI may add value to CECT in patients with biliary tract cancer both in the initial workup for staging and determination of overall resectability and in follow-up for local recurrence.     

One Versus Up-to-5 Lesion Measurements for Response Assessment by PERCIST in Patients with Lung Cancer

PurposeThe optimal number of lesions to measure for response assessment from fluorine-18 fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET)/computed tomography (CT) is not validated for lung cancer. We compared 1 lesion and up-to-5 lesion measurements for response assessment in lung cancer per PET Response Criteria in Solid Tumors (PERCIST).MethodsPatients with lung cancer with pre- and post-treatment PET/CT images were included. The standard uptake value corrected for lean body mass (SUL_peak) of up-to-5 hottest target lesions was measured at each time point. The percent changes of SUL_peak of the single hottest lesion and the sum of up-to-5 hottest lesions were computed. Pearson correlation coefficient evaluated the strength of association between the percent changes of SUL_peak values from the 1 lesion and up-to-5 lesion analyses. Response categories were complete metabolic response (CMR) with no perceptible lesion; partial metabolic response (PMR), stable metabolic disease (SMD), or progressive metabolic disease (PMD) using the threshold of 30% and 0.8 unit change in SUL_peak; and unequivocal new lesion meant PMD. The concordance for response categorization was assessed by kappa statistics.ResultsA total of 40 patients (25 non-small cell lung cancer; 15 small cell lung cancer) were analyzed, all with ¹⁸F-FDG-avid lung cancer. Average of 3 target lesions were measured for up-to-5 lesion analysis. Pearson’s r was 0.74 (P < 0.001) and increased to 0.96 (P < 0.001) when two outliers were excluded. Response categorization with 1 lesion and up-to-5 lesion analyses was concordant in 37 patients (92.5%, weighted kappa = 0.89).ConclusionAnalyzing 1 lesion and up-to-5 lesions for response assessment by PERCIST showed high concordance in patients with lung cancer.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13139-021-00697-4.