Trichinosis Caused by Ingestion of Raw Soft-Shelled Turtle Meat in Korea

Reptiles, unlike mammals, have been considered to be unsuitable hosts of Trichinella spp., though larvae have been detected in their muscles and human outbreaks related to their consumption have, in fact, occurred. Herein we report 2 Korean cases of trichinosis, possibly transmitted via consumption of reptile meat. Both patients suffered from myalgia, headache, and facial edema. Laboratory examinations revealed leukocytosis with eosinophilia (54% and 39%, respectively) and elevated creatinine phosphokinase. ELISA was performed under the suspicion of trichinosis, showing positivity at the 29th and 60th day post-infection. Since they had consumed raw soft-shelled turtle meat, turtle was strongly suggested to be an infection source of trichinosis in Korea next to the wild boar and badger.     

The fifth outbreak of trichinosis in Korea

Trichinosis is a food-borne zoonotic disease caused by the nematode, Trichinella spp., and had been reported several times in Korea. Recently, there was an additional outbreak, involving 5 patients, the findings from which are reported herein. On 30 November 2010, 8 persons ate sashimi of the meat of a wild boar. Then, 2-3 weeks later, they complained of myalgia and fever. Unfortunately, muscle biopsy was not performed, but ELISA was performed using their sera. Two people among 8 were positive for Trichinella on the 34th day post-infection (PI), and 3 patients who initially revealed negative ELISA were additionally proved to be positive for trichinosis on the 42nd day PI. Hence, the confirmed patients of trichinosis were 5 in total in the present outbreak. They were treated with albendazole and discharged uneventfully. This was the fifth outbreak of trichinosis in Korea.     

Human Trichinosis: Studies on Eleven Cases Affecting Two Families in Nova Scotia

A two-family outbreak of 11 cases of trichinosis with one fatality has been described. Efforts were made to obtain an early assessment of the severity of parasitization on the basis of initial clinical appearance, serial electrocardiograms, changes in eosinophil count, serum protein analyses and SGOT levels. The diagnoses were confirmed by muscle biopsy and by Suessenguth-Kline flocculation tests on serum. Factors portending a severe illness included: (a) rapid decline in total eosinophil count, (b) very low levels of serum albumin, (c) elevation of α₁- and α₂-fractions of serum proteins. A review of current serological methods available for the diagnosis of trichinosis has been presented and emphasis has been placed on the importance of interpreting laboratory tests in conjunction with clinical signs and symptoms. The severity and duration of illness in these cases have shown the importance of enforcing present public health regulations designed to prevent this illness being acquired by humans through consumption of infected pork.     

Human Trichinosis: Report of Four Cases,with Emphasis on Central Nervous System Involvement,and a Survey of 500 Consecutive Autopsies at the Ottawa Civic Hospital

In 1963, acute trichinosis was recognized in four patients at the Ottawa Civic Hospital. One presented with cavernous sinus thrombosis and sixth nerve palsy. A second had a severe systemic infection with myocarditis; the signs of myocarditis appeared in the third week. Electrocardiographic abnormalities included T-wave flattening, prolongation of PR interval and QRS complex, and non-specific changes in 25%. Central nervous system involvement occurred in the second week with general symptoms (headache, delirium and psychotic behaviour), followed in the third week by focal signs (nerve palsy, convulsion, pareses and coma).The incidence of trichinosis in the U.S.A. fell from 15.9% before 1948 to 4.5% in the period 1948-1963. The Canadian incidence in the period from 1940 to 1943 was 5.6%. In a survey in Ottawa using the Baermann digestion and compression methods, four positive cases were found out of 500 diaphragms examined. These figures indicate the success of the public health regulations aimed at controlling trichinosis. A gastrocnemius muscle biopsy is still an invaluable diagnostic tool, especially in critically ill patients with negative skin tests and no eosinophilia.     

Standardization of ELISA IgM and IgA for immunodiagnosis of human trichinosis

An ELISA test for trichinosis using as antigen a larvae soluble fraction from Trichinella spiralis was carried out for the detection of IgM and IgA specific antibodies in 45 serum samples from patients confirmed or suspected to have trichinosis by strong clinical and epidemiological evidences. All the patients had positive serology detected by precipitin test, bentonite floculation test, indirect hemagglutination test and ELISA IgG test. The cut-off value was determined using two criteria. Criterion A was determined in each plate, using three positive controls and two negative ones; the average of the negative controls and the weakest positive control, multiplied by a 1.2 factor was, considered the cut-off value. Criterion B was determined using the average plus three standard deviations from 64 apparently healthy persons serum samples. In both cases, three serum dilutions (1:10, 1:100 and 1:500) were used. The sensitivity of ELISA IgM was 100.0, 93.3 and 82.2% using serum dilutions of 1:10, 1:100 and 1:500 respectively (criterion A) and 100.0, 97.8 and 95.6% for the same dilutions (criterion B), whereas the values for ELISA IgA were: 100.0, 91.1 and 86.7% (criterion A) and 100.0, 100.0 and 91.1% (criterion B). In order to find out the specificity of ELISA IgM and ELISA IgA, additional 118 serum samples from individuals with other parasitoses, such as cysticercosis (18) hydatidosis (39), fascioliasis (12), toxocariasis (30), Chagas' disease (12) and individuals with non-specific eosinophilia (7), were also tested. ELISA IgM presented a specificity of 92.3, 93.4 and 97.3% (criterion A) and 96.2, 97.8 and 97.8% (criterion B) whereas the results for ELISA IgA were 97.8, 98.9 and 99.4% (criterion A) and 98.4% for the 1:10 and 1:100 dilutions and 100.0% for the 1:500 dilution (criterion B). The positive predictive values of ELISA IgM were 76.3, 77.8 and 88.1% (criterion A) and 86.5, 91.7 and 91.5% (criterion B) whereas the negative ones were 100.0, 98.3 and 95.7% (criterion A) and 100.0, 99.4 and 98.9% (criterion B). The positive predictive values of ELISA IgA were 91.8, 95.3 and 97.5% (criterion A) and 93.8, 93.8 and 100.0% (criterion B) whereas the negatives ones were: 100.0, 97.8 and 96.8% (criterion A) and 100.0, 100.0 and 97.8% (criterion B). The use of ELISA IgM and ELISA IgA in the immunodiagnosis of trichinosis is discussed.     

The indirect hemagglutination reaction in the diagnosis of trichinosis

An indirect hemagglutination test (IHAT) for trichinosis using a Melcher's antigen was evaluated and compared with a precipitin test (PT) and a bentonite flocculation test (BFT). One hundred and forty eight serum samples from patients from the whole country confirmed or suspected to have trichinosis by clinical or epidemiological evidences were studied: 117 (79.1%) samples resulted positive by IHAT, 138 (93.2%) by PT and 65 (43.9%) by BFT. Sixty three serum samples from patients with strong clinical suspect of trichinosis presented the PT and the BFT positive and were compared with the IHAT for sensitivity study. IHAT was positive in 60 (95.2%) serum samples. In order to determine the specificity of IHAT 25 serum samples from healthy volunteers and 124 serum samples from individuals with other parasitoses, such as cysticercosis (48), hydatidosis (45) and fascioliasis (31) were studied. The specificity, using a titre > or = 1:16 as a possible diagnostic value was 96%. The use of IHAT with RP and BFT in the diagnosis of human trichinosis is discussed.     

Strained meat formulas in allergic diseases of infants and children

Strained meat formulas containing approximately the protein, carbohydrate, fat and mineral content of cow's milk have proven valuable in the study of animal milk allergy in infants and children. Strained meat formulas have been given to over one hundred infants and children with bronchial asthma, eczema and gastrointestinal allergic disease. There were no instances of weight loss or anemia. Clinical improvement was evident in most cases.     

右美托咪啶对苏醒期小儿血清肌钙蛋白I、C 反应蛋白及补体的影响

目的:探究不同浓度右美托咪啶对小儿麻醉后肌钙蛋白I、C反应蛋白以及补体变化的影响。方法:收集我院下腹股沟斜疝、急性阑尾炎以及肠套叠手术患儿75例,根据治疗方法不同分为三组,每组25例,其中A组实施0.5μg/kg负荷剂量右美托咪啶治疗,B组实施0.25μg/kg负荷剂量右美托咪啶治疗,C组实施右美托咪啶0.2~0.7μg/kg/h持续泵入。对比三组患者苏醒情况、血清肌钙蛋白I、C反应蛋白、补体水平、镇定及躁动评分。结果:手术后,B组自主呼吸恢复时间、气管导管拔管时间、解除监护时间明显缩短,且与其他两组比较,差异有统计学意义(P0.05);与A、C两组相比,B组手术后C反应蛋白及血清肌钙蛋白I水平较低,而C3及C4水平较高,差异具有统计学意义(P0.05);B组镇静、躁动评分明显降低,差异有统计学意义(P0.05)。结论:0.25μg/kg负荷剂量右美托咪啶能够有效减轻患儿术后炎性反应,缓解麻醉后神经损伤,有助于脏器功能的恢复。     

2014-2016年南充市儿童手足口病重症流行病学调查及危险因素分析

摘要 目的：了解南充市儿童重症手足口病流行病学特征及其相关危险因素,为降低儿童重症手足口病发病率提供依据。方法：对中国"疾病监测信息报告管理系统"中确诊的南充市（顺庆区、高坪区、嘉陵区、阆中市）2014-2016年儿童手足口病的病例信息进行研究,分析该市儿童手足口病疫情、时间分布、地区分布和人群分布特征,并应用单因素和多因素Logistic回归分析儿童重症手足口病危险因素。结果：2014-2016年顺庆区、高坪区、嘉陵区、阆中市共报告儿童手足口病8068例,其中重症病例426例,占5.28%。全年均有手足口病发生,4~7月为手足口病发病高峰期,2014年峰值明显高于2015年、2016年,重症手足口病时间分布和发病高峰期与以上相同。顺庆区、高坪区、嘉陵区、阆中市均有手足口病发生,阆中市重症病例比例均高于其他辖区,差异有统计学意义（P<0.05）。男性患儿重症病例构成比较高,不同性别患儿重症病例构成比比较差异有统计学意义（P<0.05）;重症病例主要集中在1~3岁儿童,不同年龄段重症病例构成比比较差异有统计学意义（P<0.05）,重症病例主要分布在散居儿童和农村儿童,不同生活方式、不同家庭住址重症病例构成比比较差异有统计学意义（P<0.05）;重症病例主要分布在3~6天时间间隔的就诊患儿,不同就诊时间间隔重症病例构成比比较差异有统计学意义（P<0.05）。多因素Logistic分析显示：年龄为1-3岁、散居、家庭住址为农村是重症手足口病的危险因素（P<0.05）。结论：年龄为1-3岁、散居、家庭住址为农村是重症手足口病的危险因素,应在流动人口集中、生活条件较差的地区开展手足口病的宣传教育,提高人们对手足口病防治的认知,对于1-3岁儿童应作为疾病重点防控对象,提高家长疾病防控意识,以降低重症手足口病的发病率。     

Oral Calcium-loading Test in Infancy,with Particular Reference to Idiopathic Hypercalcaemia

An oral calcium-loading test suitable for infants is described and the usual response defined. In four acute cases of idiopathic hypercalcaemia a high and sustained rise in serum calcium occurred, suggestive of hyperabsorption and consistent with a vitamin-D-like effect. In four further infants with a milder illness suggestive of hypercalcaemia the fasting calcium levels were not grossly raised, but the test produced an exaggerated hypercalcaemic response. In this type of patient the test is more sensitive in the diagnosis of idiopathic hypercalcaemia than isolated measurements of serum calcium, especially if these are taken in the fasting state. Five patients on treatment and three whose treatment had been discontinued (but who subsequently relapsed or made a poor recovery) showed abnormal loading tests at a time when fasting calcium levels were normal. In two cases full recovery from the disease was associated with reversion of the test to normal. The test can therefore be used to indicate activity of the disease and consequently as a guide to therapy. In two cases a persistently abnormal loading test was associated with a poor long-term prognosis.     

血清胱抑素C 水平变化在支原体肺炎早期肾损伤的临床预防价值

目的:探讨血清胱抑素C水平变化对小儿支原体肺炎早期肾损伤的临床预防价值,并依据胱抑素C水平变化制定支原体肺炎患儿的临床治疗疗程及康复时间,以减少支原体肺炎的复发。方法:对临床确诊的129例为支原体肺炎的住院患儿进行胱抑素C、尿素氮、肌酐的检测。结果:肺炎支原体患儿胱抑素C水平较对照组明显升高,临床病愈患儿中有39例胱抑素C水平较正常对照组高,并有统计学意义,尿素氮水平及肌酐与正常对照组比较无明显差异,39例胱抑素C水平高的患儿在随访中有27例再次感染支原体肺炎,而90例随访结果正常者仅有9例复发支原体肺炎入院。结论:对肺炎支原体患儿进行胱抑素C的检测有助于预知肺炎支原体对肾脏的早期肾损伤及对支原体肺炎患儿的愈后判断并进行早期干预预防再次感染复发。     

Serological and biochemical factors in bovine ephemeral fever

Clinical signs of ephemeral fever, which were observed in individual cattle during two successive epidemics in 1973 and 1976, were related to biochemical, cellular and serological changes in the blood. The rise in peripheral blood neutrophil counts in samples collected from 12 sentinel cattle on a daily basis before, during and after natural disease in the two epidemics to mean peaks of 9.6-12.5 X 10(9) per litre, and fall in counts of lymphocytes to a trough of 5-7 X 10(9) per litre was found to occur on the same day as the fever peak. A fall in serum calcium levels from a normal mean of 2.55 mmol/l to 2.0 mmol/l occurred on the day clinical signs were most pronounced. Serum magnesium levels were affected to only a minor degree. Plasma fibrinogen rose from a normal mean of 5.0 milligrams to a peak of 18 milligrams on the second day of disease and fell towards normal in the week after recovery. Neutralizing antibodies to bovine ephemeral fever virus were detected up to 63 days prior to clinical disease, and the rise of antibody after recovery was secondary in pattern. Serological evidence of a prior infection with an antigenically related virus, Kimberley virus, was found in these animals. In more severe clinical cases of ephemeral fever serum calcium levels were as low as 1.95 mmol/l. Treatment of cattle showing clinical signs of the disease with phenylbutazone and calcium borogluconate was favourable.     

The changes of BPA level in 31 cases of children with aplastic anaemia and its clinical significance

Abstract. Burst-promoting activity (BPA) was measured in the sera from 31 children with aplastic anaemia (AA). BPA levels were elevated in most of the children with A A (65-2%), the mean value (137.7 ± 18.4%) being significantly higher than that in normal children (69.6 ± 9.4%), in children in the recovery period and in children with non-aplastic anaemia. There was a negative relationship between the BPA level in children with AA and the peripheral haemoglobin concentration. The BPA level was higher in those whose duration of illness was shorter than 1 year. In three cases of AA caused by chloramphenicol and benzene hexachloride and one case of congenital pure red cell AA, the BPA level was not elevated. Eleven patients received fetal liver cell suspensions intravenously (FLI). After FLI the BPA level in their sera was significantly reduced. According to these results, it appears that the elevation of BPA level is a special phenomenon of A A. The measurement of BPA in serum is helpful for differentiation between AA and other kinds of anaemia. The elevation of the BPA level in serum is a biological compensation for the haematopoietic disorder, and the measurement of BPA in the serum of patients with A A may be helpful in evaluating the haematopoietic condition.     

手足口病并发病毒性脑炎患儿的临床观察及护理

回顾性分析了52例手足口病并发病毒性脑炎的患儿的护理。总结护理经验：通过仔细的病情观察及早发现神经系统受累症状,采取早期干预,给予对症、饮食、口腔、皮肤、心理等护理措施,以阻止疾病发展,促进患儿早日康复。本组52例患儿均治愈出院,平均住院时间11.5天,无明显后遗症发生。     

The enhancement of muscle trichinosis in rabbits after immunization with heterologous serum proteins

The enhancement of muscle trichinosis in rabbits after immunization with heterologous serum proteins. International Journal for Parasitology4, 193–196. Rabbits were immunized with electrophoretically-purified rat serum albumin, β-globulin or γ-globulin in Freund's Complete Adjuvant and then inoculated with Trichinella spiralis larvae. Muscle parasitism was greatly enhanced in all the treated animals; this, plus the high levels of anti-rat and low levels of antiparasite antibody, indicates that antigenic competition can increase parasite numbers in trichinosis. Antigenic competition may play a role in the establishment of natural infections by T. spiralis by deflecting a protective immunological response by the host.     

Trichinella spiralis: Alterations of blood chemistry in the mouse

Alterations in host blood chemistry during mouse trichinosis were studied. Mice infected with Trichinella spiralis showed depressions in serum glucose, serum pyruvate, serum total cholesterol, serum bilirubin, serum alkaline phosphatase, serum total proteins, serum total globulin, uric acid, albumin, and A/G ratio below levels found in uninfected animals. The concentrations of serum lactic dehydrogenase, serum glutamic-oxaloacetic transaminase, and serum creatine phosphokinase in infected mice were above that of uninfected mice. Hemoglobin, packed-cell volume (Hematocrit), creatinine, and calcium were at similar levels in infected and uninfected mice. These changes are discussed in terms of primary pathophysiologic lesions occurring in the gut and muscles of the trichinous host.     

The role of respiratory tract viruses in the etiology of obstructive bronchitis in infants

Out of 524 children with acute respiratory infections in 141 obstructive bronchitis was diagnosed (OZO). Seventy cases could be linked to viral infection. Viral infections tested (influenza virus A, B, parainfluenza typ 1-3, RSV, adenoviruses) were more frequently associated with OZO than other acute respiratory infections of unknown etiology. Majority infections induced by influenza virus A and parainfluenza virus typ 2 were accompanied by OZO symptoms. Of the highest risk of acquiring OZO despite of viral infection participation, were children of 4-12 months of age. OZO associated viral infections prevailed during autumn-winter season, while in spring-summer period undetermined factors were the major cause of OZO. In serum samples of children with OZO, despite of etiology of the disease, higher level of IgE was found than in a group of children without the symptoms. In the case of OZO of unestablished etiology the level of serum IgE was significantly higher than in the cases when viral etiology of the disease was found.     

支原体肺炎患儿血清中相关炎性因子的表达变化情况及其临床意义探讨

目的：探讨支原体肺炎（Mycoplasma Pneumoniae Pneumonia,MPP）患儿血清中细胞因子IL-8,IL-12的表达水平及hs-CRP、IgG和血清补体（C）的变化及其临床意义。方法：收集MPP患儿50例,分为重症组、轻症组。健康儿童42例作为对照组;用ELISA法测定MPP患儿急性期、恢复期及对照组儿童血清IL-8、IL-12的水平,用血浆蛋白分析仪速率散射比浊法测定hs-CRP,Ig和C含量。结果：在急性期和恢复期MPP患儿血清IL-12含量明显低于正常对照组（P〈0.05）;而血清IL-8含量在急性期明显高于正常对照组（P〈0.01）。重症组患儿血清中IL-12明显低于轻症组,而血清中IL-8较轻症组高（P均〈0.01）。急性期MPP患儿血清IgM,IgG与对照组相比明显升高（P均〈0.01）;而IgA明显降低（P〈0.05）。急性期MPP患儿hs-CRP、C3、C4与对照组比较显著升高（分别为P〈0.01、P〈0.01、P〈0.05）。重症组患儿血清中IgM,IgG与轻症组相比明显升高（P均〈0.01）;IgA与轻症组相比明显降低（P〈0.05）;重症组患儿血清中hs-CRP、C3、C4与轻症组相比明显升高（P均〈0.01）。结论：检测相关血清炎性细胞因子对判定MPP患儿的病情和预后有较高的临床应用价值。     

Trichinosis: Thiabendazole in the Treatment of 11 Cases

We have studied 11 cases of acute human trichinosis; five of these patients were treated with thiabendazole. We have reviewed the laboratory data for these patients and described their course. This study has failed to show any definite effect of thiabendazole on the course of human trichinosis at the doses used. However, thiabendazole may have decreased the infectivity of the larvae which were embedded in the muscles of our patients.     

血清GPAA1、SF、OPN与儿童急性淋巴细胞白血病危险度的关系及对血栓发生风险的评估效能研究

摘要 目的：分析血清糖基磷脂酰肌醇锚附着蛋白1（GPAA1）、铁蛋白（SF）、骨桥蛋白（OPN）与儿童急性淋巴细胞白血病危险度的关系及对血栓发生风险的评估效能。方法：选择我院自2017年1月至2022年12月接诊的112例急性淋巴细胞白血病患儿作为观察组，另选112例性别、年龄与观察组相匹配的健康体检儿童作为对照组。检测两组血清GPAA1、SF、OPN表达水平，分析不同危险度的急性淋巴细胞白血病患儿血清GPAA1、SF、OPN表达水平的差异性，观察急性淋巴细胞白血病患儿的血栓发生情况，通过受试者工作特征曲线（ROC）下面积（AUC）评价血清GPAA1、SF、OPN预测急性淋巴细胞白血病患儿发生血栓的效能。结果：观察组血清GPAA1、SF、OPN表达水平均高于对照组（P＜0.05）；在低危、中危和高危的急性淋巴细胞白血病患儿中，血清GPAA1、SF、OPN表达水平有差异（P＜0.05）；经Spearman相关性分析，血清GPAA1、SF、OPN表达水平与儿童急性淋巴细胞白血病危险度呈正相关（P＜0.05）；在112例急性淋巴细胞白血病患儿中，发生血栓12例，占10.71%；经多因素Logistic回归分析，血清GPAA1、SF、OPN均是急性淋巴细胞白血病患儿发生血栓的独立预测因素（P＜0.05）；经ROC曲线分析，血清GPAA1、SF联合OPN预测急性淋巴细胞白血病患儿发生血栓的AUC为0.901。结论：血清GPAA1、SF、OPN与儿童急性淋巴细胞白血病危险度密切相关，联合预测患儿发生血栓的效能较好，对此病的诊治具有重要指导意义。