PURPOSE: Transfusion-transmitted virus(TTV) is an newly described nonenveloped human virus, with a circular, negative stranded DNA genome. Although a high prevalence of TTV infection in the normal population has been demonstrated, there is a still possibility of association with hepatitis according to the genotype of TTV. The aim of this study is to investigate the prevalence of TTV infection in Korean children. METHODS: Nested polymerase chain reaction(PCR) using priner sets generated from the noncoding region(NCR) of the viral genome was done in 105 children without liver disease, aged 0-15 years. We performed a second set of PCR using N22 primer in 88 children after the first set of PCR. RESULTS: The TTV DNA was detectable in 36(34%) of 105 children without hepatitis by 5'NCR primer. The prevalence of TTV varied with age:<1 y,16%(4/25); 1-3 y, 44%(15/31); 4-6 y, 31%(5/ 16); 7-9 y, 25%(3/12); 10-15 y, 14%(3/21). By using N22 primers, the prevalence of TTV DNA in children without hepatitis was 11.3%(11/88):<1 y 8%(2/25); 1-3 y, 13.7%(4/29); 4-6 y, 6.2%(1/16); 7-9 y, 33.3%(2/6); 10-14 y, 8.2%(1/12). CONCLUSION: Our result showed a high prevalence of TTV infection, varying with age, in Korean children. Further evaluation of genotypes of TTV in patients with hepatitis and normal children is needed.
Child* ; DNA ; Genome ; Genome, Viral ; Genotype ; Hepatitis ; Humans ; Liver Diseases ; Polymerase Chain Reaction ; Prevalence* ; Torque teno virus*

Dermal melanocytosis is observed in various congenital conditions including nevus of Ota, nevus of Ito and Mongolian spot. It usually appears at birth or in early childhood. Several types of acquired dermal melanocytosis which usually appear in adult life have been reported. As the late onset has been stressed, the term acquired is used. We report two cases of acquired dermal melanocytosis on the forearm and the back without any similar pigmentation elsewhere on the body. The first case is a 47-year-old man who had numerous grey-blue colored macules and patches on the upper back. Histopathologic findings showed a large number of spindle-shaped cells containing melanin granules in the dermis. On electron microscopy, dermal melanocytes with stage 3, 4 melanosomes and lipid droplet were observed. The second one is a 13-year-old girl who had a 3.8 X 2.5 cm sized dark grey colored patch on the left forearm. Histopathologic and EM finding were similar to case 1. We treated both cases with topical cream(retinoid and hydroquinone), but could not observe improvement. Their lesions have persisted without any change.
Adolescent ; Adult ; Dermis ; Female ; Forearm ; Humans ; Melanins ; Melanocytes ; Melanosomes ; Microscopy, Electron ; Middle Aged ; Mongolian Spot ; Nevus ; Nevus of Ota ; Parturition ; Pigmentation

PURPOSE: A limited number of studies have examined the link between F-wave abnormalities and clinical presentation in pediatric Guillain-Barré syndrome (GBS). Therefore, this study examined the importance of F-wave abnormalities as a prognostic factor in pediatric GBS patients. METHODS: The records and electrodiagnostic studies (EDS) of 70 GBS patients were retrospectively evaluated, and divided into 2 groups according to the results of EDS. Group A (n=33) presented with F-wave abnormalities, and group B (n=26) exhibited normal findings. We compared laboratory reports, clinical features, response to treatment, and prognosis between the 2 groups. RESULTS: Motor weakness was the most frequently observed symptom for either group. Clinically, the incidence of fever and upper respiratory symptoms differed between the 2 groups, while the prevalence of abnormal deep tendon reflex (DTR) was significantly higher in group A than B (P<0.05). Patients diagnosed with GBS had received intravenous immunoglobulin treatment: 94% in group A and 58% in group B. Furthermore, significantly greater numbers of patients in group A showed H-reflex abnormalities and poor prognosis compared with group B (P<0.05). CONCLUSION: This study demonstrated that F-waves are a clinically important prognostic factor in GBS. F-wave abnormalities were associated with abnormal DTR and poor prognosis in patients. Limited studies have examined the link between F-wave abnormalities and clinical results; therefore, further randomized controlled studies are needed to confirm the clinical characteristics and efficacy of treatments.
Child* ; Fever ; Guillain-Barre Syndrome* ; H-Reflex ; Humans ; Immunoglobulins ; Incidence ; Prevalence ; Prognosis ; Reflex, Abnormal ; Retrospective Studies

OBJECTIVE: To investigate the interaction of herpes simplex virus type 1 antigen and T cells in Behcet's disease. METHODS: Intracellular interferon-gamma response of T cells was measured before and after stimulation with herpes simplex virus type 1 in 17 patients with Behcet's disease and 20 healthy controls. The proliferation rate and the changes of CD4+/CD8+ T cell subsets were also measured. RESULTS: In the basal status, the proportions of interferon-gamma producing CD4+ or CD8+ T cells were higher in patients with Behcet's disease than healthy controls. The number of interferon-gamma producing CD4+ or CD8+ T cells in patients with Behcet's disease was significantly decreased after stimulation with herpes simplex virus (mean+/-SD, 14.6+/-6.4 % vs 10.0+/-4.7%, p=0.0052 for CD4+ T cells; 29.5+/-14.2% vs 21.2+/-11.8%, p=0.045 for CD8+ T cells), while it did not change in healthy controls (11.5+/-7.4% vs 11.2+/-6.3%, p=0.88 for CD4+ T cells; 19.8+/-15.2 vs 20.7+/-10.8, p=0.84 for CD8+ T cells). There was no difference in the proliferation rate or CD4+/CD8+ subset changes between patients with Behcet's disease and healthy controls. CONCLUSION: The stimulation of peripheral blood mononuclear cells with herpes simplex virus type 1 leads to the reduction of interferon-gamma producing T cells in patients with Behcet's disease. These findings suggest that the stimulation with herpes simplex virus type 1 antigen may reverse the interferon-gamma dominant status of the Behcet's disease.
Herpes Simplex* ; Herpesvirus 1, Human* ; Humans ; Interferon-gamma ; Simplexvirus* ; T-Lymphocyte Subsets ; T-Lymphocytes

A recent study showed that comparative sequence analysis of rpoB DNAs could reveal natural relationships in genus Mycobacterium [J Clin Microbiol. 37 (6). 1999]. rpoB DNAs showed interspecies variation and intraspecies conservation, Based on these data, we developed polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) protocols which enable species differentiation in genus Mycabacterium. When this assay was applied to 24 clinical isolates identified as M. avium complex (MAC) by biochemical test, these were successfully differentiated into M. avium and M. intracellulare. These results were concordant with those obtained by 16s rDNA analysis. It is the first report that PCR-SSCP analysis of rpoB DNA could be used for species differentiation of MAC strains.
DNA* ; DNA, Ribosomal ; Mycobacterium avium Complex* ; Mycobacterium avium* ; Mycobacterium* ; Polymerase Chain Reaction* ; Polymorphism, Single-Stranded Conformational* ; Sequence Analysis

BACKGROUND: Human cytomegalovirus (HCMV) glycoprotein B (gB) is the major envelope glycoprotein, encoded by the UL55 gene. Based on sequence variation in the UL55 gene, HCMV can be classified into four gB genotypes. Previous studies have suggested an association between HCMV gB genotypes and clinical outcome in the immunocompromised hosts. The goal of this study was to determine the distribution of HCMV gB genotypes and the effect of gB genotype in the developement of HCMV diseases in hematopoietic stem cell transplant (HSCT) recipients in Korea. MATERIALS AND METHODS: DNA was extracted from 94 blood specimen of 52 allogeneic HSCT recipients with HCMV infection. HCMV gB genotype was determined using polymerase chain reaction to amplify a region of UL55, followed by restriction fragment length polymorphism (RFLP) analysis based on RsaI and HinfI digestion. RESULTS: The distribution of gB types were as follows: gB1, 73.1% (38/52) of patients; gB2, 13.5% (7/52); gB3, 1.9% (1/52) and mixed infection (gB1 and gB2), 9.6% (5/52). While gB4 was not detected, a new genotype (described as gB7 by Trincado et al, 2000) was identified on the basis of their RFLP pattern. During average 708 days' follow up period, HCMV diseases developed in 5 patients. All of them had gB1 genotype. There was no statistically significant association between the incidence of HCMV diseases and the gB genotypes. Re-infection with gB1 strain was detected in one patient who had been previously infected with gB2. This episode was associated with fever, elevated liver enzyme and positive antigenemia. CONCLUSION: HCMV gB1 was the dominant genotype and no gB4 was detected in allogeneic HSCT recipients in Korea, which is an unique pattern compared with the previous reports. Although we can not find significant association between the HCMV diseases and the gB genotypes, genotyping of HCMV will serve in the study of pathogenesis and transmission of this virus in transplant patients. Further study is underway with large study population.
Coinfection ; Cytomegalovirus* ; Digestion ; DNA ; Fever ; Follow-Up Studies ; Genotype* ; Glycoproteins ; Hematopoietic Stem Cells* ; Humans* ; Immunocompromised Host ; Incidence ; Korea* ; Liver ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Transplantation*

BACKGROUND: Human cytomegalovirus (HCMV) glycoprotein B (gB) is the major envelope glycoprotein, encoded by the UL55 gene. Based on sequence variation in the UL55 gene, HCMV can be classified into four gB genotypes. Previous studies have suggested an association between HCMV gB genotypes and clinical outcome in the immunocompromised hosts. The goal of this study was to determine the distribution of HCMV gB genotypes and the effect of gB genotype in the developement of HCMV diseases in hematopoietic stem cell transplant (HSCT) recipients in Korea. MATERIALS AND METHODS: DNA was extracted from 94 blood specimen of 52 allogeneic HSCT recipients with HCMV infection. HCMV gB genotype was determined using polymerase chain reaction to amplify a region of UL55, followed by restriction fragment length polymorphism (RFLP) analysis based on RsaI and HinfI digestion. RESULTS: The distribution of gB types were as follows: gB1, 73.1% (38/52) of patients; gB2, 13.5% (7/52); gB3, 1.9% (1/52) and mixed infection (gB1 and gB2), 9.6% (5/52). While gB4 was not detected, a new genotype (described as gB7 by Trincado et al, 2000) was identified on the basis of their RFLP pattern. During average 708 days' follow up period, HCMV diseases developed in 5 patients. All of them had gB1 genotype. There was no statistically significant association between the incidence of HCMV diseases and the gB genotypes. Re-infection with gB1 strain was detected in one patient who had been previously infected with gB2. This episode was associated with fever, elevated liver enzyme and positive antigenemia. CONCLUSION: HCMV gB1 was the dominant genotype and no gB4 was detected in allogeneic HSCT recipients in Korea, which is an unique pattern compared with the previous reports. Although we can not find significant association between the HCMV diseases and the gB genotypes, genotyping of HCMV will serve in the study of pathogenesis and transmission of this virus in transplant patients. Further study is underway with large study population.
Coinfection ; Cytomegalovirus* ; Digestion ; DNA ; Fever ; Follow-Up Studies ; Genotype* ; Glycoproteins ; Hematopoietic Stem Cells* ; Humans* ; Immunocompromised Host ; Incidence ; Korea* ; Liver ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Transplantation*

The prevalence of heart failure (HF) is skyrocketing worldwide, and is closely associated with serious morbidity and mortality. In particular, HF is one of the main causes for the hospitalization and mortality in elderly individuals. Korea also has these epidemiological problems, and HF is responsible for huge socioeconomic burden. However, there has been no clinical guideline for HF management in Korea. 
The present guideline provides the first set of practical guidelines for the management of HF in Korea and was developed using the guideline adaptation process while including as many data from Korean studies as possible. The scope of the present guideline includes the definition, diagnosis, and treatment of chronic HF with reduced/preserved ejection fraction of various etiologies.
Aged ; Diagnosis* ; Heart Failure* ; Heart* ; Hospitalization ; Humans ; Korea ; Mortality ; Prevalence

With advancements in both pharmacologic and non-pharmacologic treatments, significant changes have occurred in heart failure (HF) management. The previous Korean HF registries, namely the Korea Heart Failure Registry (KorHF-registry) and Korean Acute Heart Failure Registry (KorAHF-registry), no longer accurately reflect contemporary acute heart failure (AHF) patients. Our objective is to assess contemporary AHF patients through a nationwide registry encompassing various aspects, such as clinical characteristics, management approaches, hospital course, and long-term outcomes of individuals hospitalized for AHF in Korea. This prospective observational multicenter cohort study (KorHF III) is organized by the Korean Society of Heart Failure. We aim to prospectively enroll 7,000 or more patients hospitalized for AHF at 47 tertiary hospitals in Korea starting from March 2018. Eligible patients exhibit signs and symptoms of HF and demonstrate either lung congestion or objective evidence of structural or functional cardiac abnormalities in echocardiography, or isolated right-sided HF. Patients will be followed up for up to 5 years after enrollment in the registry to evaluate long-term clinical outcomes. KorHF III represents the nationwide AHF registry that will elucidate the clinical characteristics, management strategies, and outcomes of contemporary AHF patients in Korea.

With advancements in both pharmacologic and non-pharmacologic treatments, significant changes have occurred in heart failure (HF) management. The previous Korean HF registries, namely the Korea Heart Failure Registry (KorHF-registry) and Korean Acute Heart Failure Registry (KorAHF-registry), no longer accurately reflect contemporary acute heart failure (AHF) patients. Our objective is to assess contemporary AHF patients through a nationwide registry encompassing various aspects, such as clinical characteristics, management approaches, hospital course, and long-term outcomes of individuals hospitalized for AHF in Korea. This prospective observational multicenter cohort study (KorHF III) is organized by the Korean Society of Heart Failure. We aim to prospectively enroll 7,000 or more patients hospitalized for AHF at 47 tertiary hospitals in Korea starting from March 2018. Eligible patients exhibit signs and symptoms of HF and demonstrate either lung congestion or objective evidence of structural or functional cardiac abnormalities in echocardiography, or isolated right-sided HF. Patients will be followed up for up to 5 years after enrollment in the registry to evaluate long-term clinical outcomes. KorHF III represents the nationwide AHF registry that will elucidate the clinical characteristics, management strategies, and outcomes of contemporary AHF patients in Korea.