Apical ballooning cardiomyopathy (Takotsubo or ampulla cardiomyopathy) is a well-known transient and localized left ventricular (LV) dysfunction characterized by apical severe hypokinesis, typical electrocardiogram (ECG) changes of negative T, and a lack of organic lesions of the coronary arteries which could cause myocardial ischemia leading to segmental asynergy. Here we report on two cases of transient cardiomyopathy showing atypically localized asynergy, which is different from Takotsubo cardiomyopathy. Case 1 was diagnosed as atypical Takotsubo cardiomyopathy, and the current findings suggest case 2 was viral myocarditis. These cases suggest that there exist variant patterns of transient cardiomyopathy, and non-invasive and serial clinical evaluations are important for differential diagnosis in acute and atypical cardiomyopathy.
Cardiomyopathy ; Acute ; Cases ; Localized ; Atypical

Acid-fast microorganisms were isolated from 240 soil samples collected at two areas, Hiroshima, Japan and Seoul, Korea. The biological and biochemical characteristics of the isolated mycobacteria were tested and compared with those of 36 reference mycobacteria Strains. The isolation rate and distribution of these mycobacterial species from soil were compared using three kinds of media with emphasis on the two methods of isolation between the different geographical areas. One Strain from each of the 10 species among atypical mycobacteria isolated from soil in both areas was inoculated into ddY mice and the pathogenicity compared with that of Mycobacterium tuberculosis H37Rv up to 6 weeks. Susceptibility of the reisolated acid-fast bacilli to antimycobacterial agents was tested in vitro. Antibody responses against various mycobacterial antigens were tested using lepromatous type and tuberculoid type patient sera by the agar gel immunodiffusion. 1) No significant differences in the distribution of acid-fast bacilli were observed between soil samples from the two regions. 2) Rapid growers were by far the most frequent acid-fast bacilli isolated while no photochromogens were isolated from these soil samples. In addition, a minimal number of fastidious mycobacteria were isolated but not cultivable in subcultures. 3) Some of these soil acid-fast bacilli were capable of inducing only transient bacteriological and pathologic changes in mouse organs. 4) Acid-fast bacilli reisolated from organs of these infected mice were, in general, found to be resistant to antimycobacterial agents. 5) M. scrofulaceum antigen showed a precipitation reaction in agar gel immunodiffusion with the highest number of sera from leprosy patients.
Animal ; Leprosy/immunology ; Mice ; Mycobacteria, Atypical/drug effects ; Mycobacteria, Atypical/isolation & purification* ; Mycobacteria, Atypical/pathogenicity ; Mycobacterium/isolation & purification* ; Mycobacterium Infections/pathology ; Soil Microbiology*

No abstract available.
Atypical Hemolytic Uremic Syndrome* ; Complement C3* ; Complement System Proteins*

We report on three elderly patients with stroke-like onset of atypical Miller Fisher syndrome (MFS). The serum titer of anti-GQ1b IgG was markedly elevated in these patients. Their prognoses were sufficiently good with immunoadsorption therapy with or without intravenous immune globulin (IVIg) therapy. However, some neurological findings were not characteristic of typical MFS. Patient 1 suffered from prolonged dysesthesia in her left extremities, and Patients 2 and 3 showed no ataxia. Moreover, complete bilateral gaze limitation is rare in MFS. The sudden stroke-like onset along with the gaze limitation of these patients suggests that the unexpected elevation in the serum titer of anti-GQ1b IgG due to unknown immune dysregulation might have severely affected the third, fourth, and sixth nerves and this potent antibody rapidly attacked these nerves and induced stroke-like clinical features and complete ophthalmoplegia.
Cerebrovascular accident ; Miller Fisher Syndrome ; Right and left ; Serum ; Atypical

No abstract available.
Humans ; Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative

The crustose lichen genus Pertusaria comprises over ca. 800 species worldwide. In total, 20 Pertusaria species were localized to the Mt. Sorak and Jeju-do in Korea. To date, information regarding the distribution of Pertusaria species in the South Korean peninsula is scarce. In this study, we collected Pertusaria species across South Korea and identified them based on morphological, chemical, and molecular characteristics. Of the 387 samples collected, we identified 24 taxa and 1 variety, of which 17 were previously recorded, and 6 taxa were newly found in South Korea (P. leioplaca, P. leucosora var. violascens, P. texana, P. thiospoda, P. thwaitesii, and P. xanthodes), 2 known species were transferred to Varicellaria (Varicellaria lactea and V. velata), one species was transferred to Variolaria as a new record (Variolaria multipunctoides) and one was a new species (P. jogyeensis J. S. Park & J.-S. Hur, sp. nov.). Characteristics of the newly discovered species, P. jogyeensis, are as follows: smooth to bumpy thallus, scattered to crowded poriform apothecia, blackish ostioles, definitely sunken, thin yellowish green rims around ostioles, 8-spored ascus, and the presence of perlatolic acid and thiophaninic acid (chlorinated xanthone). Phylogenetic studies on P. jogyeensis based on the mitochondrial small subunit sequence revealed proximity to P. flavicans and P. texana, and supported its classification as a new species within the genus Pertusaria. Additionally, we describe the chemical composition and morphology of all listed species in detail and provide an artificial key for identification.
Atypical Squamous Cells of the Cervix ; Classification ; Jeju-do ; Korea* ; Lichens*

Nontuberculous mycobacterial (NTM) infections are an increasingly recognized cause of chronic lung disease in immunocompetent adults, and the M. avium complex, M. kansasii, and a rapidly growing mycobacteria such as M. abscessus, M. fortuitum, and M. chelonae account for most of the pathogens involved. Because the clinical features of NTM disease are not distinguishable from those of tuberculosis, and NTM are ubiquitous in the environment, diagnosis requires that the bacilli are isolated and identified. NTM diseases have been difficult to treat, though since the introduction of new macrolides, the outcome for patients with some NTM diseases has improved significantly. For correct diagnosis and the successful treatment of NTM pulmonary disease, a knowledge of the full spectrum of clinical and radiological findings is important.
Adult ; Aged ; Female ; Human ; Immunocompromised Host/*immunology ; Lung Diseases/immunology/*microbiology/*radiography ; Male ; Middle Age ; Mycobacteria, Atypical/*isolation & purification ; Mycobacterium Infections, Atypical/immunology/*radiography

BACKGROUND: Infections caused by mycobacteria have been significantly increasing. Due to the difficulty of making a decision about the pathogenicity of mycobacteria, species-level identification is very important for patients' diagnosis and treatment. The purpose of this study was to identify mycobacteria species using a high performance liquid chromatography (HPLC) method and to provide an initial database for the distribution of mycobacteria in Korea. METHODS: Acid fast bacteria isolated from 3,107 clinical specimens were identified by mycolic acid analysis using HPLC. The HPLC patterns were compared with those of standard mycobacteria species. RESULTS: The HPLC patterns were divided into single, double, and triple cluster groups, each group comprising 9, 20, and 4 species, respectively. Mycobacteria and non-tuberculous mycobacteria (NTM) were identifies by HPLC at the rates of 99.5% and 95.6%, respectively. NTM was isolated in 12.4% of the mycobacteria positive specimens. This study also found that there were 20 different NTM species with the distribution of each species ranging from 0.3% to 15.9% of the total NTM. While the rate of NTM has been increasing in Korea, M. avium-intracellulare, M. fortuitum, and M. chelonae are relatively decreasing, and M. kansasii and M. gordonae are relatively increasing. CONCLUSIONS: HPLC method was highly discriminative for the identification of NTM in clinical specimens.
Bacterial Typing Techniques ; Chromatography, High Pressure Liquid/*methods ; Hospitals, University ; Humans ; Korea ; Mycobacteria, Atypical/chemistry/*isolation & purification ; Mycobacterium Infections, Atypical/drug therapy/microbiology ; Mycolic Acids/analysis

BACKGROUND: Limited data are available on the current status of cytology practices in Korea. This nationwide study presents Korean cytology statistics from 2015. METHODS: A nationwide survey was conducted in 2016 as a part of the mandatory quality-control program by the Korean Society for Cytopathology. The questionnaire was sent to 208 medical institutions performing cytopathologic examinations in Korea. Individual institutions were asked to submit their annual cytology statistical reports and gynecologic cytology-histology correlation data for 2015. RESULTS: Responses were obtained from 206 medical institutions including 83 university hospitals, 87 general hospitals, and 36 commercial laboratories. A total of 8,284,952 cytologic examinations were performed in 2015, primarily in commercial laboratories (74.9%). The most common cytology specimens were gynecologic samples (81.3%). Conventional smears and liquid-based cytology were performed in 6,190,526 (74.7%) and 2,094,426 (25.3%) cases, respectively. The overall diagnostic concordance rate between cytologic and histologic diagnoses of uterine cervical samples was 70.5%. Discordant cases were classified into three categories: category A (minimal clinical impact, 17.4%), category B (moderate clinical impact, 10.2%), and category C (major clinical impact, 1.9%). The ratio of atypical squamous cells of undetermined significance to squamous intraepithelial lesion was 1.6 in university hospitals, 2.9 in general hospitals, and 4.9 in commercial laboratories. CONCLUSIONS: This survey reveals the current status and trend of cytology practices in Korea. The results of this study can serve as basic data for the establishment of nationwide cytopathology policies and quality improvement guidelines in Korean medical institutions.
Atypical Squamous Cells of the Cervix ; Diagnosis ; Hospitals, General ; Hospitals, University ; Korea* ; Quality Improvement ; Squamous Intraepithelial Lesions of the Cervix

Bacterial morphology can be altered by various factors, including antibiotics. Unusually shaped, large, swollen organisms were observed in a urine culture obtained from a patient who had no history of antibiotic therapy. The organism was identified as Escherichia coli by the Vitek 2 system and by DNA sequencing of 16S rRNA and gyrB. The patient had no symptoms except fever, which subsided without medication. Microbiology laboratories should be aware of the potential appearance of such bacilli to avoid confusion with fungi and other naturally occurring filamentous organisms.
Anti-Bacterial Agents ; Atypical Bacterial Forms ; Escherichia ; Escherichia coli ; Fever ; Fungi ; Humans ; Sequence Analysis, DNA