• Title/Summary/Keyword: 음성적 변이

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Contrast-Enhanced Magnetic Resonance Angiography for Evaluation of the Steno-occlusive Disease of the Supraaortic Arteries: Comparison with Computed Tomography Angiography and Digital Subtraction Angiography (조영증강 자기공명 혈관조영술을 이용한 대동맥궁 위 혈관의 협착 및 페쇄 질환 평가: 전산화 단층 혈관조영술 및 디지털 감산혈관조영술과의 비교)

  • Jeh, Su-Kyung;Kim, Bum-Soo;Jung, So-Lyung;Ahn, Kook-Jin;Shin, Yong-Sam;Lee, Kwan-Sung;Kim, Young-In;Lee, Kwang-Soo
    • Investigative Magnetic Resonance Imaging
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    • v.13 no.2
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    • pp.152-160
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    • 2009
  • Purpose : To intra-individually compare diagnostic accuracy of high-resolution contrast-enhanced magnetic resonance angiography (CE-MRA) with computed tomography angiography (CTA) and digital subtraction angiography (DSA) for the assessment of supraaortic steno-occlusive disease. Materials and Methods : Twenty-eight patients (20 men, 8 women, 53-79 years of age) underwent supraaortic CE-MRA, CTA and DSA. CE-MRA was performed on two 1.5T MR scanners (voxel dimension: $0.66{\times}0.66{\times}1.1$ or $1.2\;mm^3$), and CTA on 64-slice CT scanners (voxel dimension: $0.42{\times}0.42{\times}0.63\;mm^3$). All the three examinations were completed within 40 days (median 19 days; range 1-40 days). Retrospective evaluation and measurement of diameter of 6 extracranial and 9 intracranial arterial segments was done by 2 experienced radiologists. Results: A total of 420 arterial segments were examined by CE-MRA, CTA and DSA. On DSA, 34 stenoocclusive lesions were noted at extracranial (n= 19) and intracranial (n = 15) vessels. For extracranial stenosis greater than 70%, sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) were 94.7%, 98.7%, 90.0% and 99.3% on CE-MRA, and 94.7%, 99.3%, 94.7% and 99.3% on CTA. For intracranial stenosis greater than 50%, sensitivity; specificity, PPV and NPV were 93.3%, 98.3%, 77.8%and 99.6% on CE-MRA, and 86.7%, 97.9%, 72.2% and 99.1 % on CTA, with DSA as the standard of reference. Conclusion : Supraaortic CE-MRA is as reliable as CTA in depicting the arterial stenosis, and is effective in screening of significant stenosis of both extracranial and intracranial arterial stenosis.

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Detection of Pyrazinamide-Resistant Mycobacterium tuberculosis is by PCR-SSCP of pncA Gene (pncA 유전자 PCR-SSCP법을 이용한 결핵균 Pyrazinamide 내성의 진단)

  • Shim, Tae-Sun;Kim, Young-Whan;Chin, Jae-Yong;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1178-1187
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    • 1998
  • Background : Recently the incidence of tuberculosis is increasing in many countries and control of the disease is further threatened by the emergence of multi-drug resistant tuberculosis. So rapid detection of drug resistance is very important. Pyrazinamide (PZA) is a first-line chemotherapeutic agent for tuberculosis. Now in Korea, we perform PZase activity test instead of actual pyrazinamide susceptibility test for the detection of PZA resistant M. tuberculosis. Recently the pncA gene, encoding the PZase of M. tuberculosis, was completely sequenced. And it was reported that the mutation of pncA gene would be associated with PZA resistance of M. tuberculosis. Therefore we performed this study to evaluate the possibility for the rapid detection of PZA resistant M. tuberculosis using PCR-SSCP of pncA gene. Method : 44 cultured clinical isolates of M. tuberculosis, BCG Tokyo strain. BCG French strain, and one M. bovis isolate were studied. We used H37Rv as the reference strain, The PZase activity test was done at the reference laboratory of Korean Tuberculosis Institute. DNA was extracted by bead-beater method and 561 bp fragment including pncA gene was amplified by PCR. The PCR product were digested by BstB I enzyme. SSCP was done using MDE gel. Of the 44 strains of M. tuberculosis, 22 strains were PZase-positive and other 22 strains were PZase negative. Results : Of the 22 PZase positive strains, 18 strains(82%) showed the same mobility compared with that of H37Rv and 4(18%) showed different mobility. Of the 22 PZase-negative strains, 19(86%) strains showed the same mobility pattern compared with that of H37Rv and 3(14%) showed different mobility. Naturally PZA-resistant BeG-French strain, BCG-Tokyo strain, and one M. bovis isolate showed the same band pattern each other, but their mobility were different from that of H37Rv. The results of PZase activity test and PCR-SSCP of pncA of M. tuberculosis were statistically significantly correlated each other (p<0.01). Conclusion : The PCR-SSCP after BstB I restriction of pncA gene of M. tuberculosis may be a useful method for the rapid detection of PZA-resistant M. tuberculosis.

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The Polyneuropathy in Patients with Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환 환자들의 다발성 말초신경병변에 대한 연구)

  • Baek, Jong-Cheul;Myung, Jae-Il;Kang, Heon-Seok;Kim, Yeong-Rock;Youm, Houng-Roul;Ryeu, Hyung-Seun;Lee, Soong;Kim, Wan;Noh, Jean-Yee
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.806-814
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    • 1997
  • The incidence, type and distribution of polyneuropathy in patients with chronic obstructive pulmonary disease (COPD) were assessed and also analyzed the causative factors. Forty-four patients, mean age 66.1 years (42 male, 2 female), have been investigated with arterial gas analysis, pulmonary function test, clinical and electrodiagnostic studies. None of them had conditions known to affect the peripheral nervous system such as metabolic disorders or drugs. In a selected group of 44 patients, electrophysiological findings of polyneuropathy were found in 22 patients(50%), clinical polyneuropathy were diagnosed in 13 patients(9 patients were diagnosed by electrophysiological studies, 4 patients were normal by electrophysiological studies). These findings indicate that subclinical polyneuropathy(13 patients, 30%) more commonly occurs than clinical polyneuropathy(9 patients, 20%) in associated with COPD. In the patients with polyneuropathy, the lesions were predominant axonal degeneration, the changes were more involved in leg than arm, more frequently affected sensory fibers. We could not find etiologic factor to cause polyneuropathy in COPD patients.

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Intracranial synthesis of specific IgG antibody in cerebrospinal fluid of neurocysticercosis patients (뇌유구낭미충증 환자의 뇌척수액내 특이 IgG항체의 기원)

  • 조승열;김석일
    • Parasites, Hosts and Diseases
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    • v.26 no.1
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    • pp.15-26
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    • 1988
  • To determine the source of Cysticercus·specIfic IgG antibody in cerebrospinal fluid(CSF), paired samples of serum and CSF were collected from confirmed neurocysticercosis, other neurologic diseases and normal control. The antibody levels in serum and CSF were measured by ensyme-linked immunosorbent assay (ELISA). With the measurement of total protein, albumin and IgG concentration in serum and CSF, the contribution of IgG in CSF were calculated in transudation, exudation and intracranial synthesis using the formula of Tourtellotte and Ma (1978). Mean concentrations of total protein, albumin, IgG and proportional IgG levels in CSF by transudation, exudation and intracranial synthesis were elevated in neurocysticercosis. But only the intracranial synthesis of IgG showed a statistically significant correlation with the specific IgG antibody levels in CSF. In CSF from lateral ventricle in the 4th ventricular neurocysticercosis, the protein concentrations were normal and the specific antibody levels were negative. However, in consecutively secured lumbar CSF from the same patients, the former were increased and the latter were positive. These results indicated that, in neurocysticercosis, the specific IgG antibody in CSF was a local product of intracranial synthesis.

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Antimutagenicity and Immuno Activity of Extracts from Epimedium koreanum Nakai Containing Different Icariin Quantity (Icariin 함량에 따른 삼지구엽초 추출물의 항돌연변이 및 면역활성)

  • Park, Myoung-Su;Kim, Seo-Jin;Forghani, Fereidoun;Rahman, S.M.E.;Eo, Ji-Hyun;Eun, Jong-Bang;Oh, Deog-Hwan
    • Food Science and Preservation
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    • v.18 no.6
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    • pp.938-945
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    • 2011
  • Epimedium koreanum Nakai is a wild herb commonly consumed in South Korea due to its beneficial health effects. In the present study, the antimutagenic and immunoactivities of extracts from E. koreanum Nakai containing different icariin quantities were investigated for food use. In the Ames test, both the water and ethanol extracts were found not to have a mutagenic effect on Salmonella typhimurium TA98 and TA100, respectively. The E. koreanum Nakai extracts showed over 80 and 90% antimutagenic effects on benzo(${\alpha}$)pyrene (B(a)P) in S. typhimurium TA98 and TA100, respectively. Moreover, all the extracts showed over 70% antimutagenicity on S. typhimurium TA98 and TA100 against 4-nitroquinoline-1-oxide (4NQO). The E. koreanum Nakai extract with ethanol showed strong antimutagenic activity, higher than that of the water extract and the sequenced KE9412, KE9408, and KE9405. In the immunomodulating activity test, the effect of E. koreanum Nakai on the B (Rhamos) and T (Jukat) cells were investigated. The immunoactivity results showed that the growth and viability of the B and T cells increased and were activated more in KE9405 (1.8 times), KE9408 (1.6 times), and KE9412 (1.32 times) in the water extracts, and least in KE9412 (1.74 times), KE9408 (1.52 times), and KE9405 (1.4 times) in the ethanol extracts. In the case of both the water and ethanol extracts ($500{\mu}g/mL$) from E. koreanum Nakai, the highest cell number of the human B (Rhamos) and T (Jukat) cells was observed on day 4 in KE9405 and KE9412, and on day 5 in KE9408. Based on the obtained results, the development of E. koreanum Nakai as a food material is recommended.

A clinical review of community acquired methicillin resistant staphylococcal scalded skin syndrome (지역사회 획득 메치실린 내성 포도알균에 의한 포도알균 열상 피부 증후군의 임상적 고찰)

  • Heo, Soon Young;Song, Yoon Jeong;Kim, Sung Jun;Park, Sun Young;Kang, Du Cheul;Ma, Sang Hyuk
    • Pediatric Infection and Vaccine
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    • v.14 no.1
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    • pp.83-90
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    • 2007
  • Purpose : Staphylococcal scalded skin syndrome (4S) is a well known disease defined by clinical, microbiological and histological criteria caused by Staphylococcus aureus. This disease is uncommon but has been increasingly recognized. We investigated the clinical features of staphylococcal scalded skin syndrome. Methods : We reviewed retrospectively medical records of 53 patients diagnosis of staphylococcal scalded skin syndrome who were admitted to Changwon Fatima hospital from February 2002 to December 2005. These patients were divided into 3 clinical types; generalized type, intermediate type, abortive type. Age, sex ratio, clinical manifestations, laboratory findings, response to therapy and prognosis were investigated. Result : 1)The mean age of patients was 2.8 years, ranging from 20 days to 7 years. Male-to-female ratio was 1.9:1. 2) By clinical types, 6 patients were in the generalized type (11%), 29 patients in the intermediate type (55%), 18 patients in the abortive type (34%). The coexisting diseases were variable, including conjunctivitis (25 cases), atopic dermatitis (11 cases), otitis media (1 case). On laboratory findings, most of patients didn't have leukocytosis or increased C-reactive protein. 4) A total of fifteen Methicillin Resistant Staphylococcal Aureus (MRSA) strains were isolated from September 2003 through December 2005. Fourteen strains were positive for exfoliative toxin B gene by PCR and negative for enterotoxin, toxic shock syndrome toxin and Panton-Valentine leukocidin genes. 5) The mean duration of admission was 7.3 days. Patients were treated with vancomycin or amoxacillin/clavulanate or ampicillin/sulbactam or cefuroxime without significant sequelaes. Conclusion : Recently, Staphylococcal scalded skin syndrome caused by exfoliative toxin B produced by MRSA in the Changwon area has been increasing.

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Surgical Treatment of Multidrug-resistant Pulmonary Tuberculosis (다제내성 폐결핵의 수술적 치료)

  • Kim, Jin Hee;Min, Jin Hong;Park, Jun Ho;Park, Seung Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.6
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    • pp.613-618
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    • 2005
  • Background : Recently, medical treatment of multi-drug resistant pulmonary tuberculosis has been unsuccessful. Through analyzing the cases with surgical treatment, we hope to provide some help in treating multi-drug resistant pulmonary tuberculosis in the future. Material and Method : A retrospective review was performed with 138cases of surgical treatment of multi-drug resistant tuberculosis during 10years from January 1994 to December 2003 at National Masan Hospital. Results : The ratio of men to women, 5.1:1 indicates that there were more incidences in men. The number of the resistant drugs was 5.3 with a mean age of 42.6 years. Cavitary lesions on the plain chest X-rays were seen in 94cases (68.1%). 128cases had positive sputum culture preoperatively. Types of operations were 24 pnemonectomies, 83 lobectomies, 10 bilobectomies, 19 lobectomies with segmentectomies or wedge resections, 1 wedge resection, and 1 carvenoplasty. There was no death after operation. There were 6cases of air leakage over a week, 6cases of postoperative bleeding, 8cases of bronchopleural fistula and empyema, 16cases of dead space, 1case of atelectasis, 1case of wound infection, 1case of cyst as postoperative complication. Postoperative complication showed higher long-term negative conversion rate of 92.8%. Conclusion : There has been many discussions about operative indications, postoperative drug regimens, length of postoperative chemotherapy. In our study, we showed higher long-term success rate of postoperative chemotherapy with pulmonary resection on multi-drug resistant pulmonary tuberculosis.

Clinical Characteristics, Histology and Prognosis of Autoimmune Hepatitis in Korean Children (소아 자가면역성 간염: 임상적 특성, 조직 소견 및 예후)

  • Chung, Dae-Lim;Seo, Jeong Kee;Yang, Hye Ran;Ko, Jae Sung;Park, Sung Hye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.2
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    • pp.186-196
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    • 2004
  • Purpose: Autoimmune hepatitis is a chronic inflammatory liver disease with unknown cause that is characterized by liver histology, circulating autoantibodies and increased levels of immunoglobulin G. Only sporadic reports are available on autoimmune hepatitis in children. The aim of this study was to evaluate the clinical, biochemical, and histological features, and the long-term outcome of autoimmune hepatitis in Korean children. Methods: We reviewed the medical records of 14 children diagnosed as having autoimmune hepatitis at Seoul National University Children's Hospital from 1990 to 2004, and analyzed clinical, biochemical, and histological features, and clinical outcomes. Results: Mean age at diagnosis was 9 years and 11 of the 14 children were female. Six children presented with acute hepatitis-like manifestations. Jaundice and fatigue were the most common symptoms. Other autoimmune diseases accompanied in 6 children. Anti-nuclear antibody was detected in 13 patients and anti-smooth muscle antibody was positive in 8. All 14 patients were type 1 autoimmune hepatitis. The main histologic findings were interface hepatitis, rosette formation, and cirrhosis. Clinical and biochemical features were improved in six patients treated with ursodeoxycholic acid. Eight patients were treated with corticosteroid alone or in combination with azathioprine and five of them are in biochemical remission. Conclusion: Autoimmune hepatitis is an inflammatory liver disease, which has a favorable long-term outcome if it is diagnosed and treated promptly. Therefore, autoimmune hepatitis should be suspected in children with chronic hepatitis of unknown etiology, especially in female patients who show hypergammaglobulinemia or some clinical features of autoimmune disease.

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Physioecological Characteristics and Phylogenetic Relationships Based on Multivariate Analysis on Colocasia antiquorum Schott (토란의 생리.생태적 특성 및 다변량 해석법을 통한 유연관계 분석)

  • Choi, Kyeong-Gu;Yoo, Nam-Hee
    • Korean Journal of Medicinal Crop Science
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    • v.5 no.3
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    • pp.177-185
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    • 1997
  • Twenty-four major ecological and physiolosical characters of the 54 accessions of taro(Colocasia antiquorum) were observed in the growing seasons of 1995 and 1996 in $Ch{\breve{o}}nju$, Korea. The average days to emergence of the 54 accessions were 21.7 and the accession which had the shortest days to emergence was Kurye #2. Petiole color of most accessions was green, except $Ich{\breve{o}}n$ #1, Iri #1, Puan #1 and Taiwan #1 which had purple petioles. All the accessions had cormels except Taiwan #1 which had long runners without cormels. Average yield of the accessions was 3,719 kg/10a and total carmel weight, average carmel number, average carmel and average corm weight were 787g/plant, 39.2/plant, 20.3g/cormel, and 263.6g/plant, respectively. Accessions $Ch{\breve{o}}ngju$ #1 and Wanju #1 showed superiority in the three important characters, total carmel weight/plant, average carmel weight, and corm weight. Multivariate analysis for the 24 characters indicated that petiole color and carmel type had relatively higher coefficient of variation, 56.8 and 44.4 %, respectively. Fifty four taro accessions could be classified into 11 groups with D(${\sqrt{D^{2}}$) value of 110 on the basis of phenotypical characteristics. Most accessions were inclued in Group II. The Group I in which Taiwan #1 was included was genetically the most distant from the other groups. Accessions with purple petioles were grouped into the three different subgroups in which green petiole accessions were not included, indicating high dissimilarity between the different petiole color accessions. All the accessions grouped into the Group VIII, $Ch{\breve{o}}ngju$ #1, Wanju #1, Wanju #3, and $Taech{\breve{o}}n$ #2, had higher bioogical yield. Some accessions collected from the same district showed a high dissimilarity by being classified into the different subgroups.

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Clinical Characteristics of Elderly Patients with Pulmonary Tuberculosis (고령자 폐결핵에 대한 임상적 관찰)

  • Kim, Chung-Tae;Um, Hye-Suck;Lee, Hyang-Ju;Rhu, Nam-Soo;Cho, Dong-Il
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.4
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    • pp.432-440
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    • 2000
  • Background : The prevalence of pulmonary tuberculosis among the elderly is increasing in Korea and in the developed countries due to the increased elderly population and their predispositions to chronic disease, poverty and decreased immunity. To define the characteristics of pulmonary tuberculosis in the elderly, we evaluated the clinical spectrum of pulmonary tuberculosis. Method : We analyzed 92 patients retrospectively that were diagnosed as active pulmonary tuberculosis over the age of 65. The analysis involved patient's profiles, clinical manifestations, coexisting diseases, diagnostic methods, anti-TB medications and their side effects, and treatment outcomes. Results : The results were as follows : - 1) The ratio of male to female was 2.1:1(62:30 cases) 2) Chief complaints were a cough (47.8%), dyspnea (40.2%), sputum (38.0%), chest pain (12.0%), anorexia (10.9%), and fever (9.8%). 3) 38 (41.3%) of cases had a past history of pulmonary tuberculosis. 4) The coexisting diseases were : -COPD, 25 cases (27.2%); pneumonia, 17 cases (18.5%); DM. 13 cases (14.1%); and malignancy, 10 cases (10.9%). 5) The positivity of Mantoux test (5 TU, PPD-S) was 82.7%. 6) Pulmonary tuberculosis was diagnosed using the following methods : sputum AFB (Acid Fast Bacillus) smear 42.4%, sputum TB (M. Tuberculosis) culture 15.2%, sputum TB PCR (Polymerase Chain Reaction) 10.9%, bronchial washing AFB smear 2.1%, chest radiology only 25.0%. 7) Locations of radiologic lesions were RULF, 50 cases; RLLF, 50 cases, mostly, then LLLF ; 26 cases were leastly involved. 8) The coexisting tuberculosis were endobronchial TB(8.7%), TB pleurisy(7.6%) miliary TB(5.4%), intestinal TB(2.2%), renal TB(1.1%) 9) The proportion of treatment regimen with 1st line drug and 2nd line drug were 92.3% and 7.6%, respectively. 10) The outcome of treatment were as follows : cured 31.5%, expired 13.0%, no return 47.8%, follow-up now 7.6%. Conclusion : The pulmonary tuberculosis in the elderly has atypical patterns with chronic coexisting diseases. Therefore, the possibility of pulmonary tuberculosis should be considered in elderly patients with pulmonary symptoms.

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