The ultraviolet radiation (UVR) is known to be a potent modulator of many host immune functions and the exposure of experimental animals to the inflammatory effects of UVR induces depressions in their ability to initiate and effectuate various types of cellular immune responses. In this study, the effects of UV-B (280 320 nm) radiation on resistance to a facultative intracellular bacterium, Listeria monocytogenes (LM), were examined at the cellular level. The numbers of cultivable LM recovered from the spleens of UV-B-irradiated mice were decreased at 2 days postinfection compared with those of untreated control mice. However, the acquired immunity, developed 7 days after immunization with streptomycin (SM)-sensitive LM, in either UV-irradiated, LPS- or IL-1-pretreated mice was less stronger than that developed in untreated, control mice. To elucidate the possible mechanisms underlying the observation that UVR did increase innate immunity but decreased acquired immunity of mice to the infection with LM, the effects of UVR of mice on the production of IFN-r by activated splenocytes and TNF-a by peritoneal macrophages were assessed. Activated splenocytes from UV-irradiated mice exhibited a reduced capacity to produce IFN-r and cultured peritoneal macrophages produced more TNF-a in the presence of LPS during 24 hours after UV radiation. Though TNF-r activity was not detected in the sera of LM-infected mice, intravenous LPS injection induced TNF-r production and UVR decreased TNF activity in sera obtained from LM-infected mice with LPS induction 9 days after irradiation. Although Ia-negative macrophages were predominant in the peritoneal macrophages from untreated control mice, the infection of mice with LM caused a marked increase in Ia expression on peritoneal macrophages. However, UVR resulted in decreased expression of Ia molecule on the peritoneal macrophages during the LM infection. These findings suggest that the dual effects of UVR on the innate and acquired immunity of mice to the LM infection may be associated with altered capacities of splenocytes and peritoneal macrophages of the mice to produce cytokines, in addition to decrease of la molecule expression on the macrophages.
Adaptive Immunity ; Animals ; Cytokines ; Depression ; Immunity, Cellular ; Immunity, Innate ; Immunization ; Listeria monocytogenes* ; Listeria* ; Macrophages ; Macrophages, Peritoneal ; Mice* ; Spleen ; Streptomycin ; Tumor Necrosis Factor-alpha*

Bacillus anthracis, the etiological agent of anthrax, has been taxonomically classified into Bacillus subgroup I with B. cereus, B. mycoides, and B. thuringiensis based on their phenetic and genetic charateristics. Especially, DNA studies indicated that these species were closely related hence these species has been proposed as a single species with four subspecies. There has been controversy about taxonomy of B. anthracis isolates because none of the simple and rapid identification methods are available for closely related taxa so far. In this study, we have used VNTR analysis for reidentification of 7 strains of B. anthracis and 9 strains of closely related species. In the PCR analysis, All of the B. anthracis had a variable region of DNA sequence exception with Youngdungpo. One polymorphisms were found by the presence of four copies with the 12-bp tandem repeat sequences except Kunja. Of the closely related species, the equal size of (VNTR)' was amplified from Bacillus spp. Kyungjoo 3 and B. cereus. The sequences of Kyungjoo 3 was identical with B. anthracis. Whereas the tandem repeat sequences was not found in B. anthracis Kunja and B. cereus. Therefore, B. anthracis Kunja was finally reidentified as a B. cereus. As a results, the analysis of VNTR could be used for rapid identification for B. anthraicis from B. anthracis closely related taxa and molecular epidemiological studies of anthrax.
Anthrax ; Bacillus anthracis* ; Bacillus* ; Base Sequence ; Classification ; DNA ; Evolution, Molecular* ; Gyeongsangbuk-do ; Korea* ; Polymerase Chain Reaction ; Tandem Repeat Sequences*

Multiple synchronous malignancies are defined as the occurrence of two or more primary malignant tumors whose pathogenetic processes are believed to be independent or unrelated. Multiple synchronous biliary carcinomas are not frequently reported. The diagnosis is often made as a result of incidental intraoperative discovery of a gallbladder mass during surgical treatment of extrahepatic cholangiocarcinoma. We experienced a case of synchronous double primary cancer of the gallbladder and distal common bile duct confirmed by pathologic evaluation, and report the case with a review of the clinical literature.
Biliary Tract* ; Cholangiocarcinoma ; Common Bile Duct ; Diagnosis ; Gallbladder ; Gallbladder Neoplasms

Splenic abscesses in the tropics assume importance because of their unusual aetiology. They may be secondary or primary. Splenic tuberculosis is rare and a delay in diagnosis is common. The authors report a patient with splenic and mesenteric tuberculosis who was admitted to the hospital because of an abdominal cyst incidentally detected on ultrasonogram during prenatal fetal monitoring in the Department of Obsterics. The patient had already been treated with anti-tuberulous drugs for the previous 18 months after being diagnosed as tuberulous pleuritis. Abdominal sonography and computerized tomography revealed the presence of multiple hypoechoic and hypodense splenic lesions and mesenteric cysts. Diagnostic splenectomy and excision of the mesenteric cysts revealed multiple necrotic masses in the spleen, consistent with the microscopic findings of caseating granulomatous inflammation. Following splenectomy, the patient was also treated with an anti-tuberculosis regimen with no recurrence of symptoms.
Abscess* ; Diagnosis ; Fetal Monitoring ; Humans ; Inflammation ; Mesenteric Cyst ; Pleurisy ; Recurrence ; Spleen ; Splenectomy ; Tuberculosis ; Tuberculosis, Splenic ; Ultrasonography

A-57-year-old male patient suddenly developed cramping pain in the left lower abdomen with a slight abdominal distension. He had undergone a laparoscopic nephrectomy for transitional cell carcinoma 7 days earlier. An abdominal CT scan revealed a dilated small bowel loop and an internal hernia was suspected. Surgery revealed a herniation of the jejunal loop through defects in the retroperitoneum, which was successfully reduced. We report a case of an internal hernia following a laparoscopic nephrectomy. To the best of our knowledge, this is the only reported case of an internal hernia as a complication of laparoscopic nephrectomy.
Abdomen ; Carcinoma, Transitional Cell ; Hernia* ; Humans ; Laparoscopy ; Male ; Muscle Cramp ; Nephrectomy* ; Tomography, X-Ray Computed

BACKGROUND AND OBJECTIVES: Cardiac myxomas are uncommon. Early diagnosis and treatment are essential to reduce morbidity or mortality. Before 1970, preoperative diagnosis was difficult. With the development of echocardiography, a correct diagnosis is made before operation. We reviewed our clinical experience in diagnosis and management of 52 cases of myxomas seen over a 33-year period, 1966 to 1998. PATIENTS AND METHODS: There were 20 males (38%) and 32 females (62%);age range 7 - 80. All the patient's medical records were reviewed. In twenty-five patients in whom echocardiographic features could be reviewed, clinical fetures were compared according to two distinct echocardiographic features;Round and polypoid type. RESULTS: Eighty-four percents of the presenting symptoms were cardiac origin while systemic embolism (SE) accounted for 15%. Echocardiography was used most often for diagnosis. The myxomas were located in the left atrium in 50 (96%), right atrium in 2 (4%). One patient had multiple myxoma. The incidence of SE was significantly higher in polypoid type than in round type (58% vs 0%, p<0.05). Multivariate regression analysis revealed polypoid type was the only independent predictor of SE (p=0.0029). Follow-up duration was ranged from 1 to 266 months. There was no deaths associated with myxoma. One patient presented with a recurrence 3 years after resection, and reoperation was performed uneventfully. CONCLUSION: Due to the nonspecific presentation of myxoma, a high index of suspicion is needed. Surgical excision of myxoma can be considered curative with excellent long-term result. However, because of high possible occurrence of SE, a close attention should be given to those patients who have myxoma of polypoid type.
Diagnosis ; Early Diagnosis ; Echocardiography ; Embolism ; Female ; Follow-Up Studies ; Heart Atria ; Humans ; Incidence ; Male ; Medical Records ; Mortality ; Myxoma* ; Recurrence ; Reoperation

PURPOSE: The incidence of multiple primary malignant tumor has ranged from 0.7% to 11% in the medical literature. Various organs in the digestive system are the sites of multiple primary cancer (MPC). MPC may be synchronous or metachronous depending on the interval between their diagnosis. To the best of our knowledge, there are only rare reports of resected cases of synchronous primary carcinomas that developed in the GB and duodenum. METHODS: We present here a patient who underwent an operation for synchronous primary carcinomas of the GB and duodenum. A 51-year-old female was admitted for postprandial abdominal discomfort. CT scan and MRI of the abdomen showed a 3 x 2 cm sized heterogenously enhancing mass in the GB and a 3.7 x 2.7 cm sized hetrogenously enhancing mass in the 2nd portion of the duodeum. The laboratory findings, including the tumor markers, were non-specific. An elective operation was done under the impression of combined GB cancer and cancer in the 2nd portion of the deuodenum. On the operative findings, there was a 3 x 2.5 cm sized mass in the GB and a 5 x 4 cm sized duodenal mass with near complete luminal obstruction 3 cm distal from the pyloric ring. Radical cholecystectomy with wedge resection of the liver bed and Whipple's operation was performed. RESULTS: On microscopic examination, the GB mass was well differentiated adenocarcinoma and the duodenal mass was moderately differentiated adenocarcinoma, and one lymph node (a lymph node along the common hepatic artery) among the 18 dissected lymph nodes was invaded by tumor cells. The microscopic findings showed that the GB mass and duodenal mass were synchronous primary carcinomas. The patient recovered uneventfully and is alive and doing well without evidence of recurrence at 21-months of follow up evaluation. CONCLUSIONS: We report here on a case of combined curative resection for synchronous primary carcinomas of the gallbladder and duodenum.
Abdomen ; Adenocarcinoma ; Cholecystectomy ; Diagnosis ; Digestive System ; Duodenum* ; Female ; Follow-Up Studies ; Gallbladder* ; Humans ; Incidence ; Liver ; Lymph Nodes ; Magnetic Resonance Imaging ; Middle Aged ; Phenobarbital ; Recurrence ; Tomography, X-Ray Computed ; Biomarkers, Tumor

BACKGROUND: Early identification of pathogens can improve the prognosis of patients with ventilator associated pneumonia (VAP). In the present study, we evaluated the feasibility of performing multiplex PCR for endotracheal aspirates to detect three important pathogens (P. aeruginosa, K. pneumoniae and MRSA) in patients with VAP. METHODS: The endotracheal aspirates of 24 patients were collected within 24 hours of the diagnosis of VAP for performing multiplex PCR. Forward and reverse primers were designed to target the specific site of each pathogen (the oprL gene for P. aeruginosa, 16S rRNA for K. pneumoniae and the mec gene for MRSA). We analyzed the clinical data of the VAP patients, including the culture reports for the endotracheal aspirates. RESULTS: Twenty-four patients (M:F=18:6, mean age=70+/-11) with VAP were enrolled. Pathogens were isolated from 11 patients (P. aeruginosa in 2, K. pneumoniae in 1, MRSA in 2, other enteric Gram negative bacilli in 3, S. pneumoniae in 2 and mixed infection in 1). Multiplex PCR detected three cases of P.aeruginosa (2 cases coincided with the culture reports) and four cases of K. pneumoniae (1 matched with the culture report). PCR detected two MRSA cases, which did not coincide with the culture reports. CONCLUSION: Multiplex PCR of the endotracheal aspirate showed some ability to detect Gram negative bacilli, although caution is required when interpreting the results.
Coinfection ; Humans ; Methicillin-Resistant Staphylococcus aureus ; Multiplex Polymerase Chain Reaction ; Pneumonia ; Pneumonia, Ventilator-Associated ; Polymerase Chain Reaction ; Prognosis ; Ventilators, Mechanical

INTRODUCTION: Transthoracic fine needle aspiration biopsy(TNAB) has shown to be a resonably safe, simple, and accurate procedure in diagnosis of intrathoracic lung lesions. We reviewed the results of 1,005 TNAB of chest lesions performed on 930 patients with 20 or 22-gauze needles over a period of 10 years. METHODS: From November 1983 to June 1995, 1,005 cases in 930 patients with an undiagnosed lung lesion underwent TNAB at the Hanyang University Hospital: 66% were men and 34% were women. Most of the patients were 40~60 years old and the youngest patient was 3 years of age. RESULT: 540 patients had various malignant chest lesions and 322 patients had benign pulmonary lesions. The diagnostic accuracy of TNAB was 96.1 percent in malignant diseases with one false positive result and 90.1% in benign diseases. A definitive diagnosis was not obtained in the remaining 68 patients. The most common diagnoses among 519 malignancy chest lesions with TNAB were the following: squamous cell lung carcinoma, 31.7%; adenocarcinoma, 24.7%; small cell lung carcinoma, 16.7%; metastatic cancer, 14.2%; large cell lung carcinoma, 6.2% and so on. Complications included pneumothorax in 12.3% necessitating chest tube drainage in 0.6%. Minor hemoptysis occurred in 3.6%. There was no death directly attributable to the procedure. CONCLUSION: We concluded that TNAB permits a direct approach to all kinds of localized lung lesions with a high degree of accuracy and without major complications.
Adenocarcinoma ; Biopsy* ; Biopsy, Fine-Needle* ; Chest Tubes ; Diagnosis ; Drainage ; Female ; Hemoptysis ; Humans ; Lung ; Male ; Needles ; Pneumothorax ; Small Cell Lung Carcinoma ; Thorax

BACKGROUND AND PURPOSE: In order to improve inter-rater reliability and minimize diagnosis of undetermined etiology for stroke subtype classification, using a stroke registry, we developed and implemented a magnetic resonance imaging (MRI)-based algorithm for acute ischemic stroke subtype classification (MAGIC). METHODS: We enrolled patients who experienced an acute ischemic stroke, were hospitalized in the 14 participating centers within 7 days of onset, and had relevant lesions on MR-diffusion weighted imaging (DWI). MAGIC was designed to reflect recent advances in stroke imaging and thrombolytic therapy. The inter-rater reliability was compared with and without MAGIC to classify the Trial of Org 10172 in Acute Stroke Treatment (TOAST) of each stroke patient. MAGIC was then applied to all stroke patients hospitalized since July 2011, and information about stroke subtypes, other clinical characteristics, and stroke recurrence was collected via a web-based registry database. RESULTS: The overall intra-class correlation coefficient (ICC) value was 0.43 (95% CI, 0.31-0.57) for MAGIC and 0.28 (95% CI, 0.18-0.42) for TOAST. Large artery atherosclerosis (LAA) was the most common cause of acute ischemic stroke (38.3%), followed by cardioembolism (CE, 22.8%), undetermined cause (UD, 22.2%), and small-vessel occlusion (SVO, 14.6%). One-year stroke recurrence rates were the highest for two or more UDs (11.80%), followed by LAA (7.30%), CE (5.60%), and SVO (2.50%). CONCLUSIONS: Despite several limitations, this study shows that the MAGIC system is feasible and may be helpful to classify stroke subtype in the clinic.
Arteries ; Atherosclerosis ; Classification* ; Diagnosis ; Humans ; Magic ; Magnetic Resonance Imaging ; Recurrence ; Stroke* ; Thrombolytic Therapy