PURPOSE: Procalcitonin (PCT) is a current, frequently used marker for severe bacterial infection. The aim of this study was to assess the ability of PCT levels to differentiate bacteremic from nonbacteremic patients with fever. We assessed whether PCT level could be used to accurately rule out a diagnosis of bacteremia. MATERIALS AND METHODS: Serum samples and blood culture were obtained from patients with fever between August 2008 and April 2009. PCT was analyzed using a VIDAS(R) B.R.A.H.M.S PCT assay. We reviewed the final diagnosis and patient histories, including clinical presentation and antibiotic treatment. RESULTS: A total of 300 patients with fevers were enrolled in this study: 58 with bacteremia (positive blood culture) (group I); 137 with local infection (group II); 90 with other diseases (group III); and 15 with fevers of unknown origin (group IV). PCT levels were significantly higher in patients with bacteremia than in those with non-bacteremia (11.9 +/- 25.1 and 2.5 +/- 14.7 ng/mL, respectively, p < 0.001). The sensitivity and specificity were 74.2% and 70.1%, respectively, at a cut-off value of 0.5 ng/mL. A serum PCT level of < 0.4 ng/mL accurately rules out diagnosis of bacteremia. CONCLUSION: In febrile patients, elevated PCT may help predict bacteremia; furthermore, low PCT levels were helpful for ruling out bacteremia as a diagnosis. Therefore, PCT assessment could help physicians limit the number of prescriptions for antibiotics.
Bacteremia/blood/*diagnosis ; Biological Markers/blood ; C-Reactive Protein/analysis ; Calcitonin/*blood ; Early Diagnosis ; Female ; Fever/blood/*diagnosis/etiology ; Fever of Unknown Origin/blood/diagnosis/microbiology ; Humans ; Male ; Middle Aged ; Protein Precursors/*blood ; Sensitivity and Specificity ; Young Adult

No abstract available.

OBJECTIVE: Tributyltin (TBT), an endocrine disrupting chemical, has been reported to decrease ovarian function by causing apoptosis in the ovary, but the mechanism is not fully understood. Therefore, we examined whether TBT increases the expression of adipogenesis-related genes in the ovary and the increased expression of these genes is associated with apoptosis induction. METHODS: Three-week-old Sprague-Dawley rats were orally administered TBT (1 or 10 mg/kg body weight) or sesame oil as a control for 7 days. The ovaries were obtained and weighed on day 8, and then they were fixed for terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) or frozen for RNA extraction. Using the total RNA of the ovaries, adipogenesis- and apoptosis-related genes were analyzed by real-time polymerase chain reaction (PCR). RESULTS: The ovarian weight was significantly decreased in rats administered 10 mg/kg TBT compared to that in control rats. As determined by the TUNEL assay, the number of apoptotic follicles in ovary was significantly increased in rats administered 10 mg/kg TBT. The real-time PCR results showed that the expression of adipogenesis-related genes such as PPARgamma, aP2, CD36, and PEPCK was increased after TBT administration. In addition, apoptosis-related genes such as TNFalpha and TNFR1 were expressed more in the TBT-administered rats compared with the control rats. CONCLUSION: The present study demonstrates that TBT induces the expression of adipogenesis- and apoptosis-related genes in the ovary leading to apoptosis in the ovarian follicles. These results suggest that the increased expression of adipogenesis-related genes in the ovary by TBT exposure might induce apoptosis resulting in a loss of ovarian function.
Adipogenesis ; Animals ; Apoptosis ; DNA Nucleotidylexotransferase ; Female ; In Situ Nick-End Labeling ; Ovarian Follicle ; Ovary ; PPAR gamma ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction ; Receptors, Tumor Necrosis Factor, Type I ; RNA ; Sesame Oil ; Trialkyltin Compounds ; Tumor Necrosis Factor-alpha

OBJECTIVE: Tributyltin (TBT), an endocrine disrupting chemical, has been reported to decrease ovarian function by causing apoptosis in the ovary, but the mechanism is not fully understood. Therefore, we examined whether TBT increases the expression of adipogenesis-related genes in the ovary and the increased expression of these genes is associated with apoptosis induction. METHODS: Three-week-old Sprague-Dawley rats were orally administered TBT (1 or 10 mg/kg body weight) or sesame oil as a control for 7 days. The ovaries were obtained and weighed on day 8, and then they were fixed for terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) or frozen for RNA extraction. Using the total RNA of the ovaries, adipogenesis- and apoptosis-related genes were analyzed by real-time polymerase chain reaction (PCR). RESULTS: The ovarian weight was significantly decreased in rats administered 10 mg/kg TBT compared to that in control rats. As determined by the TUNEL assay, the number of apoptotic follicles in ovary was significantly increased in rats administered 10 mg/kg TBT. The real-time PCR results showed that the expression of adipogenesis-related genes such as PPARgamma, aP2, CD36, and PEPCK was increased after TBT administration. In addition, apoptosis-related genes such as TNFalpha and TNFR1 were expressed more in the TBT-administered rats compared with the control rats. CONCLUSION: The present study demonstrates that TBT induces the expression of adipogenesis- and apoptosis-related genes in the ovary leading to apoptosis in the ovarian follicles. These results suggest that the increased expression of adipogenesis-related genes in the ovary by TBT exposure might induce apoptosis resulting in a loss of ovarian function.
Adipogenesis ; Animals ; Apoptosis ; DNA Nucleotidylexotransferase ; Female ; In Situ Nick-End Labeling ; Ovarian Follicle ; Ovary ; PPAR gamma ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction ; Receptors, Tumor Necrosis Factor, Type I ; RNA ; Sesame Oil ; Trialkyltin Compounds ; Tumor Necrosis Factor-alpha

BACKGROUND: Respiratory viral infections can become epidemic due to high contagiosity. Since there was no rapid diagnostic method for complete diagnosis in the past, diagnosis was solely made on the basis of clinical symptoms or the time of infection. With recent developments in rapid diagnostic methods like multiplex reverse transcriptase (RT)-PCR, R-mix virus culture, etc., early detection and effective treatment of respiratory viral infections is possible. Herein, we compared the efficiency of multiplex RT-PCR and the R-mix virus culture for the rapid detection of respiratory viruses. METHODS: We used 96 nasopharyngeal swab specimens for culturing respiratory viruses using R-mix (Diagnostics Hybrids Inc., USA). Afterwards, multiplex RT-PCR was performed using specimens stored at -70degrees C. RESULTS: R-mix virus culture yielded positive results in 34 cases (35.4%) and multiplex RT-PCR in 73 cases (76.0%). Both methods yielded identical results in 51 cases (29 positive cases and 22 negative cases). Among 45 cases that showed different results, 40 showed negative results in R-mix virus culture and positive results in multiplex RT-PCR, and 1 showed positive result in R-mix virus culture and negative result in multiplex RT-PCR. Different viruses were detected in the remaining 4 cases by both the methods. CONCLUSIONS: Multiplex RT-PCR provided faster results and had higher detection rates than R-mix virus culture. Further, unlike R-mix virus culture, multiplex RT-PCR can be used to identify new respiratory viruses. Therefore, multiplex RT-PCR is more useful than R-mix virus culture in the diagnosis of respiratory virus infection.
Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; RNA, Viral/analysis ; Reagent Kits, Diagnostic ; Respiratory Tract Infections/*virology ; Retrospective Studies ; *Reverse Transcriptase Polymerase Chain Reaction ; *Virus Cultivation ; Virus Diseases/*diagnosis ; Viruses/genetics/*isolation &purification

BACKGROUND: Blood culture is the definitive method for the diagnosis and treatment of bacteremia and fungemia. Analysis of blood cultures positive for pathogenic species and trends in antimicrobial susceptibility can help delineate appropriate and experimental treatment strategies. In this study, we investigated the incidence of pathogenic species and trends in antimicrobial susceptibility in blood cultures collected from 2003 to 2007 to help clinicians to determine the best methods of diagnosis and treatment. Changes between previously published analyses and this study were also investigated. METHODS: Five-year blood culture results obtained at Kyung Hee University Hospital between 2003 and 2007 were analyzed to determine the bacterial and fungal species present and the antimicrobial susceptibility of the isolates. Antimicrobial susceptibility was tested by the broth microdilution method and the CLSI disk diffusion method. RESULTS: Among the 66,437 blood cultures, 5,645 were positive. Of the positive blood cultures, 59.8% were positive for aerobic and facultative anaerobic gram-positive cocci. Coagulase-negative staphylococci (CoNS) were frequently isolated. The numbers of anaerobic species and fungi decreased over the years. CONCLUSION: CoNS were the microorganisms most commonly isolated from blood cultures at Kyung Hee University Hospital. The number of cultures positive for fungi was higher than that reported in previous studies, but the absolute isolation rate over five years decreased. Anaerobic species were much less frequently isolated than reported for other hospitals.
Bacteremia ; Diffusion ; Fungemia ; Fungi ; Gram-Positive Cocci ; Humans ; Incidence

Although trisomy 18 (Edwards' syndrome) or the terminal deletion syndromes of 18p and 18q have been occasionally detected, pseudoisodicentric chromosome 18 is a very rare constitutional chromosomal abnormality. We describe a case of pseudoisodicentric chromosome 18q without mosaicism, which was confirmed from fetal cells in the amniotic fluid used for prenatal diagnosis of multiple congenital anomalies. A 23-yr-old pregnant woman was suspected of having a fetal anomaly at 18(+3) weeks gestation. In sonography, the fetus showed multiple anomalies: bilateral overt ventriculomegaly in the brain, ventricular septal defect and valve anomaly in the heart, bilateral club foot, polydactyly, meningocele, and a single umbilical artery. The pregnancy was terminated and a conventional G-banded chromosome study was performed using amniotic fluid. Twenty metaphase cells among the cultured amniocytes showed a 46,XX,psu idic(18)(q22). Consequently, the fetus had partial trisomy (18pter-->q22) and partial monosomy (18q22-->qter). Both parents were confirmed to have a normal karyotype.
Abnormalities, Multiple/diagnosis/*genetics ; Centromere ; *Chromosomes, Human, Pair 18 ; Female ; Gestational Age ; Humans ; Karyotyping ; Pregnancy ; Prenatal Diagnosis/*methods ; Trisomy ; Ultrasonography, Prenatal ; Young Adult

We report a recent case in which ciprofloxacin-resistant Shigella flexneri was isolated from a 23-yr-old female patient with a history of travel to India. Prior to her admission to our internal medicine department, she experienced symptoms of high fever and generalized weakness from continuous watery diarrhea that developed midway during the trip. S. flexneri was isolated from the stool culture. Despite initial treatment with ciprofloxacin, the stool cultures continued to show S. flexneri growth. In the susceptibility test for antibiotics of the quinolone family, the isolate showed resistance to ciprofloxacin (minimum inhibitory concentration [MIC], 8 microg/mL), norfloxacin (MIC, 32 microg/mL), ofloxacin (MIC, 8 microg/mL), nalidixic acid (MIC, 256 microg/mL), and intermediate resistance to levofloxacin (MIC, 4 microg/mL). In molecular studies for quinolone resistance related genes, plasmid borne-quinolone resistance genes such as qnrA, qnrB, qnrS, aac(6')-Ib-cr, qepA, and oqxAB were not detected. Two mutations were observed in gyrA (248C-->T, 259G-->A) and 1 mutation in parC (239G-->T). The molecular characteristics of the isolated S. flexneri showed that the isolate was more similar to the strains isolated from the dysentery outbreak in India than those isolated from Korea.
Anti-Bacterial Agents/pharmacology ; Bacterial Proteins/genetics/metabolism ; Drug Resistance, Bacterial/drug effects ; Dysentery, Bacillary/microbiology ; Feces/microbiology ; Female ; Humans ; India ; Mutation ; Quinolones/*pharmacology ; Shigella flexneri/drug effects/*isolation & purification/metabolism ; Travel ; Young Adult

No abstract available.

BACKGROUND: Unexpected antibodies are important factors for hemolytic transfusion reactions. In the past, the tube method was used for detecting unexpected antibodies. The column agglutination method has recently been widely used because of its simplicity and it has a higher rate of detecting warm antibodies. In this study, we describe the frequency and distribution of unexpected antibodies in transfusion candidates during the recent 4 years and the transfusion characteristics in the identified cases. METHODS: Antibody screening tests were carried out on 44,008 sera using the column agglutination method from January, 2005 to December, 2008. The antibodies were screened and identified by the Ortho BioVue System (Ortho-Clinical Diagnostics, Raritan, NJ, USA). RESULTS: Of the 44,008 cases that underwent unexpected antibodies screening, 589 cases (1.3%) showed positive results. Unexpected antibodies were identified in 383 cases. The antibodies that were most frequently detected were anti-Lewis antibodies in 130 cases (34.0%). Among the warm antibodies, anti-Rh and anti-Kidd antibodies were detected in 67 cases (17.5%) and 2 cases (0.5%), respectively. Unidentified antibodies were detected in 133 cases (38.9%). Among the patients with unexpected antibodies, 137 cases (35.8%) had a history of previous transfusion and 244 cases (63.7%) had a history of previous transfusion or gestation. CONCLUSION: Anti-Lewis cold antibodies were the most frequently detected antibodies. Warm antibodies were also frequently detected, and these are clinically significant.
Agglutination ; Antibodies ; Blood Group Incompatibility ; Cold Temperature ; Humans ; Mass Screening