BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) has a heteroresistant nature, so methicillin resistance is influenced by various culture conditions, such as temperature, incubation time, and NaCl content in the medium. Mueller Hinton (MH) agar containing 2% NaCl and mannitol salt agar (MSA) with oxacillin disk were evaluated for the detection of methicillin resistance. METHODS: Disk diffusion test on plain Mueller- Hinton (MH) agar, 2% NaCl MH agar, and MSA with 1 microgram oxacillin disk was performed in 70 Stap hylococcus aureus isolates. Oxacillin MIC was determined by E-test. As a gold standard of methicillin resistance, mecA gene was amplified by PCR and detected by agarose gel electrophoresis. RESULTS: Plain MH agar could not detect heterogeneous resistance in 12 S. aureus isolates (18%), but 2% NaCl MH agar and MSA could correctly detect homogeneous and heterogeneous resistance. S. aureus isolates from stool have as much as 48% heterogeneous resistance, while those from non-stool specimen have 5%. CONCLUSION: 2% NaCl and MSA can be used reliably for accurate susceptibility testing of methicillin resistance in routine laboratory.
Agar* ; Diffusion ; Electrophoresis, Agar Gel ; Mannitol* ; Methicillin Resistance* ; Methicillin* ; Methicillin-Resistant Staphylococcus aureus ; Oxacillin ; Polymerase Chain Reaction ; Staphylococcus aureus* ; Staphylococcus*

No abstract available.
Cerebellar Nuclei* ; Myoclonus*

PURPOSE: We evaluated the results of allograft reconstruction following wide resection of malignant bone tumors in long bone, retrospectively. MATERIALS AND METHODS: Seven patients were included. The mean age was 44 years old. Male was 4 cases, and female was 3 cases. Mean follow-up period was 38 months. The mean Musculoskeletal Tumor Society (MSTS) score at final follow-up was evaluated. Postoperative complications were evaluated via periodic radiologic follow-up. Oncologic results were analyzed at final follow-up. RESULTS: The primary malignancies occurred at femur in 5 cases, humerus in 1 case and tibia in 1 case. Pathologic diagnoses were osteosarcoma in 4 cases, multiple myeloma in 2 cases and adamantinoma in 1 case. Mean length of allograft was 165 mm. Fixations of allograft were intramedullary nailing with additional plate in 4 cases, intramedullary nailing in 2 cases, and screw fixation in 1 case. Mean time to union was 14.5 weeks. Mean MSTS score at final follow-up was 20 (67%). Postoperative complications were nonunion in 3 cases, implant failure in 1 case, and infection in 1 case. Oncologic outcomes were continuous disease free in 5 cases and alive with disease in 2 cases at final follow-up. Autologous bone graft and hemi-cortical onlay graft were performed in 2 cases of nonunion. CONCLUSION: Allograft reconstruction following wide resection of malignant bone tumors in long bone was effective surgical option. However, the possibility of nonunion between host bone and allograft should be considered.
Adamantinoma ; Allografts* ; Diagnosis ; Female ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Humans ; Humerus ; Inlays ; Male ; Multiple Myeloma ; Osteosarcoma ; Postoperative Complications ; Retrospective Studies ; Tibia ; Transplants

Purpose: This study evaluated the short-term safety of resident-performed intravitreal injections. Methods: We retrospectively reviewed the medical records of 503 patients (503 eyes) treated for the first time in our hospital from January 2018 to October 2020 via intravitreal bevacizumab, ranibizumab, aflibercept, or triamcinolone acetonide injections by residents or retina specialists. In terms of short-term ophthalmic complications, patients were followed-up 1 day, 1 week, and 1 month after injection. Results: A total of 503 eyes of 503 patients were included. Intravitreal injections were given to 211 and 292 eyes by residents (the resident group) and retina specialists (the retina specialist group), respectively. There were no between-group differences in baseline characteristics except in terms of the indications for injection. Intraocular pressure elevation >5 mmHg occurred in two eyes (0.95%) in the resident group and five (1.71%) in the retina specialist group, but the difference was not statistically significant. Subconjunctival hemorrhage occurred in 29 eyes (13.74%) of the resident group and 32 eyes (10.96%) of the retina specialist group; again, the difference was not statistically significant. No case of noninfectious endophthalmitis occurred in the resident group but two (0.68%) cases occurred in the retina specialist group; again, the difference was not significant. There were two (0.95%) cases of infectious endophthalmitis in the resident group and one (0.34%) case in the retina specialist group; again, the difference was not significant. No corneal erosion, traumatic lens damage, vitreous hemorrhage, or retinal tearing or detachment were noted in either group. Conclusions Resident-performed intravitreal injections appear to be safe.

STUDY DESIGN: Retrospective study. PURPOSE: Associations among risk factors related to adjacent segmental disease (ASD) remain unclear. We evaluated the risk factors and segmental lordosis ratio to prevent ASD developing after lumbar spinal fusion. OVERVIEW OF LITERATURE: Risk factors related to ASD development are age, sex, obesity, pre-existing degeneration, number of fusion segments, and decreased postoperative lumbar lordosis (LL). However, the associations among these factors are still unclear and should be clearly identified. METHODS: We retrospectively reviewed data on 274 patients who underwent lumbar spinal fusion of three segments or below for lumbar degenerative disease from January 2010 to December 2012, with over 5 years of follow-up. Patients with preoperative sagittal vertical axis (SVA) >5 cm were excluded due to sagittal imbalance. A total of 37 patients with ASD and 40 control patients (CTRL) were randomly selected in a similar distribution of matching variables: age, sex, and preoperative degenerative changes. Sex, age, number of fusion segments, radiologic measurements, L4–5–S1/L1–S1 LL ratio, and spinopelvic parameters (pelvic incidence [PI], pelvic tilt [PT], sacral slope [SS], and SVA) were analyzed. Logistic regression was used to analyze the correlation between PI–LL mismatch and L4–5–S1 segmental lordosis rate. RESULTS: No significant difference was found between ASDs and CTRL groups regarding age, sex, number of fusion segments, fusion method, and preoperative and postoperative spinopelvic parameters (PI, SS, PT, and LL). However, regarding the L4–5–S1/L1–S1 lordosis ratio, 50% (p=0.045), 60% (p=0.031), 70% (p=0.042), 80% (p=0.023), and 90% (p=0.023) were statistically significant; <20% (p=0.478), 30% (p=0.223), and 40% (p=0.089) were not statistically significant. In the postoperative PI–LL <10 group, ASD occurred less frequently than in the PI–LL >10 group, and the difference was statistically significant (p=0.048). CONCLUSIONS: Patients with a postoperative L4–5–S1/L1–S1 lordosis ratio >50% had less occurrence of ASD. Correcting LL according to PI and physiologic segmental lordosis ratio is important in preventing ASD.
Animals ; Follow-Up Studies ; Humans ; Incidence ; Logistic Models ; Lordosis ; Methods ; Obesity ; Retrospective Studies ; Risk Factors ; Spinal Fusion

BACKGROUND: The weak D is characterized serologically by a weak or negative agglutination reaction with polyclonal anti-D in an immediate-spin test and agglutination is enhanced in the indirect antiglobulin test. Weak D has a lower number of D antigen or weaker antigen density than are normal D positive red cells. Here we studied the cause of weak D antigenicity at genetic level and compared to that of normal D RBCs. METHODS: The amplification of RHD gene and RHCcEe gene site was done in normal D(n=20), weak D(n=8), D negative group(n=20) by polymerase chain reaction and by based on D typing in these individuals compared to that of serologic D typing. In addition, to detect RHD gene mutation and nucleotide sequence difference of weak D group compared to normal D RBCs, single stranded conformational polymorphism PCR was simultaneuosly perfomed in two group by RHD amplified product(189 bp). We analysis the correlation RHD genotyping and serological phenotyping, and also analysis the difference of nucleotide sequence between two group in genetic level. RESULTS: The RHD genotyping was completely matched normal D(n=20), D negative group(n=20) but weak D group(n=8) showed same genotype of normal D RBCs. In single stranded conformational polymorphism PCR, weak D phenotypes does not show any abnormalities at the genomic level when compared to the RHD gene in normal D phenotypes. CONCLUSIONS: RHD PCR showed good correlation with conventional serologic test but weak D genotype was same as that of normal D RBCs. The weaker immunogenicity of weak D is not explained by genomic DNA difference itself.
Agglutination ; Base Sequence ; Coombs Test ; DNA ; Genotype ; Phenotype ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Serologic Tests

The human colorectal carcinoma-associated GA733 antigen epithelial cell adhesion molecule (EpCAM) was initially described as a cell surface protein selectively expressed in some myeloid cancers. Gangliosides are sialic acid-containing glycosphingolipids involved in inflammation and oncogenesis. We have demonstrated that treatment with anti-EpCAM mAb and RAW264.7 cells significant inhibited the cell growth in SW620 cancer cells, but neither anti-EpCAM mAb nor RAW264.7 cells alone induced cytotoxicity. The relationship between ganglioside expression and the anti-cancer effects of anti-EpCAM mAb and RAW264.7 was investigated by high-performance thin-layer chromatography. The results demonstrated that expression of GM1 and GD1a significantly increased in the ability of anti-EpCAM to inhibit cell growth in SW620 cells. Anti-EpCAM mAb treatment increased the expression of anti-apoptotic proteins such as Bcl-2, but the expression of pro-apoptotic proteins Bax, TNF-alpha, caspase-3, cleaved caspase-3, and cleaved caspase-8 were unaltered. We observed that anti-EpCAM mAb significantly inhibited the growth of colon tumors, as determined by a decrease in tumor volume and weight. The expression of anti-apoptotic protein was inhibited by treatment with anti-EpCAM mAb, whereas the expression of pro-apoptotic proteins was increased. These results suggest that GD1a and GM1 were closely related to anticancer effects of anti-EpCAM mAb. In light of these results, further clinical investigation should be conducted on anti-EpCAM mAb to determine its possible chemopreventive and/or therapeutic efficacy against human colon cancer.
Animals ; Antibodies, Monoclonal/*immunology/*therapeutic use ; Antigens, Neoplasm/*immunology ; Apoptosis/drug effects ; Cell Adhesion Molecules/*immunology ; Cell Line ; Cell Line, Tumor ; Cell Proliferation/drug effects ; Colon/drug effects/immunology/metabolism/pathology ; Colonic Neoplasms/*drug therapy/genetics/*immunology/pathology ; Gangliosides/genetics/*immunology ; Gene Expression Regulation, Neoplastic/drug effects ; Humans ; Male ; Mice ; Mice, Inbred BALB C

No abstract available.

BACKGROUND: The resistance of Streptococcus pneumoniae to penicillin has been rapidly increasing during the recent three decades. In Korea, we found the incidence of penicillin resistance (PR) to pneumococci was 81% for the clinical isolates in our hospital, and 89% for the colonizing isolates of day-care center around Seoul. Alterations in penicillin-binding protein (PBP) 2B gene have been known to be associated with a resistance to penicillin. We tried to reveal the characteristics of PR of Korean pneumococcal strains through sequencing analysis of PBP 2B gene. METHODS: We determined the nucleotide sequences of 346 bp of a variable region among PBP 2B gene for 12 PR strains and 6 penicillin susceptible (PS) strains isolated in Korea. Phylogenetic tree using PAUP program was made to compare our DNA sequences with those of South African strains. RESULTS: Sequence homology of PS strains was ranged from 99.4% to 100% in Korean PS strain compared to reference strain, R6, except one strain (93.9%). PR strains showed homology of 95.1% to 100% compared to the South African 56762 strain. Phylogenetic analysis based on 346 bp of PBP 2B gene showed that Korean and South African strains formed different monophyletic groups according to the PR/PS patterns. Five specific amino acid changes compared to the PS R6 strain in the position 228, 232, 233, 244, and 261 were noted with a decreased hydrophilicity by Kyte-Doolittle assay. CONCLUSIONS: Our data suggest that the amino acid changes in the PBP 2B are associated with PR in S. pneumoniae, and that a part of Korean PR strains might be originated from a South African PR strain.
Base Sequence ; Colon ; Hydrophobic and Hydrophilic Interactions ; Incidence ; Korea* ; Penicillin Resistance ; Penicillin-Binding Proteins* ; Penicillins ; Pneumonia ; Seoul ; Sequence Homology ; Streptococcus pneumoniae* ; Streptococcus*

We present a case of orthotopic liver transplantation in 63 year-old female patient with liver cirrhosis, who is the record of the oldest recipient in Korea. The donor was 20 year-old male patient with subarachnoidal hemorrhage. The operation time was 12 hours. The duration of cold ischemic time and anhepatic phase were 8 hours and 85 minutes respectively. After operation the patient resumed clear consciousness. The ventilator was weaned and removed. On the third postoperative day, reoperation was required due to hemoperitoneum. Splenectomy was performed for a tearing in the hilum. After reoperation, acute renal failure and sepsis developed. Continous arteriovenous hemofiltration was continued for 3 weeks. The patient was discharged on postoperative 59th day. The patient is doing well with normal liver function. No episode of acute rejection occurred until now. More aggressive approach has been feasible in organ transplantation for older patients by advanced knowledge of perioperative management. We conclude that age over 60 years should not be a barrier to liver transplantation.
Acute Kidney Injury ; Cold Ischemia ; Consciousness ; Female ; Hemofiltration ; Hemoperitoneum ; Hemorrhage ; Humans ; Korea* ; Liver Cirrhosis ; Liver Transplantation* ; Liver* ; Male ; Middle Aged ; Organ Transplantation ; Reoperation ; Sepsis ; Splenectomy ; Tissue Donors ; Transplants ; Ventilators, Mechanical ; Young Adult