Shigella sonnei KNIH104S, which was selected by Korean National Institute of Health, expresses form I-antigen as a somatic antigen. In this study, we cloned the genes responsible for form I-antigen synthesis from S. sonnei KNIH104S. A Sau3AI-generated cosmid library of S. sonnei KNIH104S plasmids were transfected into E. coli LE392 and transfectants were tested for agglutination with antiserum against S. sonnei form I-antigen. A clone, JH222, showing the strongest agglutination activity was chosen for further analysis. A recombinant cosmid, pJH222, was isolated from the strain JH222 and retransfected into E. coli LE392. All of the transfectants agglutinated with antiserum against form I-antigen, indicating that pJH222 carried the genes required for S. sonnei form I-antigen synthesis. Restriction analysis of pJH222 revealed a 38 kb insert, which was confirmed by Southern hybridization analysis to be present on a large plasmid of S. sonnei KNIH104S.
Agglutination ; Clone Cells* ; Cloning, Organism* ; Cosmids ; Plasmids ; Shigella sonnei* ; Shigella*

Primary intracranial melanoma is uncommon. These tumors most commonly occur at the temporal lobe, cerebellum and cerebellopontine angle. We report a case of intracranial malignant melanoma of the occipital lobe in a 60-year-old man who presented with headache and visual disturbance. The mass showed hyperintensity on T1-weighted images and hypointensity on T2-weighted magnetic resonance images. He underwent gross total removal of tumor and received radiotherapy. Followup imaging studies showed neither recurrence nor any signs of residual disease for 4 months.
Cerebellopontine Angle ; Cerebellum ; Follow-Up Studies ; Headache ; Humans ; Melanoma* ; Middle Aged ; Occipital Lobe ; Radiotherapy ; Recurrence ; Temporal Lobe

PURPOSE: The purpose of this study was to evaluate the clinical course and pregnancy outcome according to operative management of appendictis in the Department of Surgery. METHODS: We reviewed the charts of pregnant patients who went through a convential appendectomy and a laparoscopic appendectomy at the Department of Surgery, Catholic University of Korea St. Mary's Hospital, from May 1995 to June 2006. RESULTS: The incidence of acute appendicitis during pregnancy was the highest at the 2nd trimester and at ages from 25 to 30 years. The laparoscopic appendectomy was shorter than the open appendectomy in hospital stay and decreased leukocytosis faster in the first postoperative day, except in cases of perforated appendicitis, but the operation times were similar. There was a significant difference in gestational age at delivery between perforated appendicitis and suppurative. We found one fetal anomaly, but it was not related to either the appendicitis or the operation method. CONCLUSIONS: In this study, we found that a laparoscopic appendectomy was better than an open appendectomy for recovery and was safe in pregnant appendicitis patients at any gestational age. However, follow up and investigation in a larger population is needed to get more accurate results.
Appendectomy ; Appendicitis ; Female ; Follow-Up Studies ; Gestational Age ; Humans ; Incidence ; Korea ; Laparoscopy ; Length of Stay ; Leukocytosis ; Pregnancy ; Pregnancy Outcome

OBJECTIVE: It has been demonstrated that cervical laminoplasty is an effective and safe method of treating multi-level cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament. However, recent reports have suggested that axial neck pain is frequently encountered after cervical laminoplasty. The aim of the present study was to determine clinical significance of the C7 spinous process on axial neck pain after cervical laminoplasty. METHODS: A total of 31 consecutive patients that underwent cervical laminoplasty between March 2002 and December 2008 were reviewed. The authors evaluated and compared axial neck pain and lordotic angle in patients that underwent C7 spinous process preserving surgery (group 1, n = 16) and in patients in which the C7 spinous process was sacrificed (group 2, n = 15). RESULTS: Severe or moderate early axial pain occurred in 56.2% of patients in group 1 and in 86.6% in group 2. Severe or moderate late axial pain occurred in 12.5% in group 1 and in 73.3% in group 2. Eighty-Six percent of patients in group 2 and 43% in group 1 experienced aggravation of their axial neck pain during the early postoperative period. Aggravation of axial neck pain during early postoperative period was less common in group 1 but not statistically significant (p = 0.073). Sixty-six percent of patients in group 2 and 12% in group 1 had aggravated axial neck pain at late postoperative period and aggravation of late axial neck pain was significantly less common in group 1 (p = 0.002). CONCLUSION: The present study demonstrates that C7 spinous process preserving laminoplasty decreases the incidence of aggravated axial neck pain after cervical laminoplasty.
Humans ; Incidence ; Longitudinal Ligaments ; Neck ; Neck Pain ; Postoperative Period ; Spinal Cord Diseases

An indirect porcine epidemic diarrhea (PED) virus (PEDV) enzyme-linked immunosorbent assay (ELISA) was compared with the serum neutralization (SN) test by testing 46 samples from experimentally infected sows, 73 samples from naive sows, and 1, 024 field sow samples from 48 commercial swine farms of undefined PED status. The SN test and the ELISA were performed using PEDV, KPEDV-9 strain. Viral proteins as a coating antigen of PEDV ELISA were extracted from the cytoplasm of PEDV-infected Vero cells using a non-ionic detergent, Triton X-100, and a simple protocol of PEDV ELISA was followed. The presence of antibodies in these experimental samples was confirmed by SN and ELISA in which the sensitivity of the ELISA was 89.1%, and the corresponding specificity was 94.5%. On testing 1, 024 field samples, an overall agreement of 84.2% was generated between the SN and ELISA. This study demonstrates that the PEDV ELISA is a useful serodiagnostic screening test at herd level for detecting swine antibodies against PEDV.
Animals ; Antibodies, Viral/blood ; Coronavirus Infections/diagnosis/*veterinary/virology ; Diarrhea/diagnosis/*veterinary ; Enzyme-Linked Immunosorbent Assay/veterinary ; Female ; Neutralization Tests/veterinary ; Sensitivity and Specificity ; Swine ; Swine Diseases/diagnosis/*virology

PURPOSE: Primary sclerosing cholangitis (PSC) is a rare condition that can be associated with inflammatory bowel disease (IBD). The aim of this study was to evaluate PSC and its association with IBD in children. METHODS: We retrospectively enrolled 13 pediatric patients (<18 years) with PSC treated at Asan Medical Center between June 1989 and December 2013. Clinical findings and long-term outcomes were investigated. During the same period, the incidence of PSC among IBD patients was evaluated among 600 Crohn disease (CD) and 210 ulcerative colitis (UC) patients. RESULTS: All 13 study patients diagnosed with PSC also presented with IBD. Eleven boys and two girls with a median age of 15.0 years old (9.0-17.8 years) were included. The cumulative incidence of PSC for UC was 5.7% (12 of 210) and 0.2% for CD (1 of 600), respectively. PSC occurred during follow-up for IBD for five patients (38.5%) whereas, IBD developed during follow-up for PSC for two patients (15.4%), and was diagnosed during the initial work-up for PSC for 6 patients (46.2%). For the 77.3 month median follow-up period, 9/13 patients (69.2%), neither the clinical symptoms nor blood test results worsened. Two cases (15.4%) developed liver cirrhosis and underwent liver transplantation. Among 13 PSC patients with IBD, two (15.4%) developed colorectal cancer, and no one developed cholangiocarcinoma. CONCLUSION: All patients with PSC in this study had associated IBD. The incidence of PSC was not rare compared to reports in adults. PSC should be considered during the management of IBD and vice versa in children.
Adult ; Child* ; Cholangiocarcinoma ; Cholangitis, Sclerosing* ; Chungcheongnam-do ; Colitis, Ulcerative ; Colorectal Neoplasms ; Crohn Disease ; Female ; Follow-Up Studies ; Hematologic Tests ; Humans ; Incidence ; Inflammatory Bowel Diseases* ; Liver Cirrhosis ; Liver Transplantation ; Retrospective Studies

Breast cancer is a common malignancy in women and metastasizes to the liver, the lung, the brain, and the bone, but metastasis to the colon is rare. We describe a 58-year-old woman with colon metastasis of breast cancer. She was diagnosed with right colon cancer, and during investigation for colon cancer, we found a breast cancer. She received a palliative right hemicolectomy due to obstruction before chemotherapy. The histology of the tissue taken from the right colon was shown to be the same as that of the left breast mass. This is a case of colonic metastasis from breast cancer and we report this case with a review of literature.
Brain ; Breast ; Breast Neoplasms ; Colon ; Colonic Neoplasms ; Female ; Humans ; Liver ; Lung ; Middle Aged ; Neoplasm Metastasis

PURPOSE: Intestinal intussusception in adults is a rare entity and its clinical course and etiology differ from pediatric counterpart. About 90% have a primary pathologic lesion, especially malignancy consists of etiology as 30% in small bowel and 66% in large bowel. The purpose of this study is to investigate of accurate diagnosis, treatment, and timing of operation by review of clinical symptom, physical examination, laboratory finding, pathologic finding, and operation finding of adult intussusception patients. METHODS: We studied 20 adult patients who were diagnosed as intussusception between July 1993 and September 2005. Intussusception by operation and rectal prolapse were excluded. Clinicopatholgic findings were analyzed retrospectively through the medical record. RESULTS: There was 15 males and 5 females in all 20 patients, and mean age was 52.3 years with a range of 29 to 78 years. Preoperative diagnosis was suspected in 14 of 20 patients (70%). We performed emergency operation in 8 cases (40%) and elective operation in 12 cases (60%). Two cases of them which preoperative diagnosis were strangulation and peritonitis accompanied with small bowel necrosis and leukocytosis. There were 12 small bowel lesions (60%) and 6 colonic lesions (30%). In two cases, there were no primary lesions. Of the cases with a defined cause, 12 cases were malignant (60%) and 6 cases were benign (30%). CONCLUSION: The most useful diagnostic method is computed tomography to reveal adult intussusception. Two cases of all were strangulated and also had a leukocytosis. In adult intussusception, most common cause is malignancy. If there is no evidence of strangulation such as leukocytosis, we recommend that elective surgery is adequate.
Adult* ; Colon ; Diagnosis ; Emergencies ; Female ; Humans ; Intussusception* ; Leukocytosis ; Male ; Medical Records ; Necrosis ; Peritonitis ; Physical Examination ; Rectal Prolapse ; Retrospective Studies

Tailgut cysts (TGCs) are rare congenital lesions arising from remnants of the postanal gut, which normally involutes by the 8th wk of embryonic development (the 3-8 mm stage). They are usually found in the retrorectal or presacral space. They often present in middle aged women with perirectal symptoms. CEA producing adenocarcinoma from a TGC is extremely rare, but such cases have recently been reported in the literature. The diagnosis has to differentiate between carcinomas of the colorectum, hamartomas, lymphomas, teratomas, chordomas, abscess formation, dermoid cysts, epidermoid cysts and enteral cysts. An elevated level of CEA may point to malignancy, but other causes must be excluded. Complete surgical resection is the therapy of choice. We report here on a case of a tailgut cyst that occurred in a 72-year-old male suffering from pneumoconiosis, and this patients showed unusual findings such as an unusual location and an elevated serum CEA level.
Abscess ; Adenocarcinoma ; Aged ; Chordoma ; Dermoid Cyst ; Embryonic Development ; Epidermal Cyst ; Female ; Hamartoma ; Humans ; Lymphoma ; Male ; Middle Aged ; Pneumoconiosis ; Pregnancy ; Stress, Psychological ; Teratoma

The lipoma is the neoplasm of mesenchymal origin. Although most lipomas occur on the trunk and the proximal portion of the extremities, lipomas of the oral and maxillofacial regions are relatively rare, approximately 13% of all cases. Lipomas have been found in all age, but usually found between 40 and 60 years of age. Clinically the lipoma is a painless, slowly growing, nearly always benign soft mass. The treatment of choice is a surgical excision, and the recurrence is rare. But the infiltrating lipoma originated from muscle has high recurrence rate. It has ill-defined border and little or no evidence of encapsulation. Histologically there is a consistent infiltration with dissociation of the surrounding muscle fiber. The infiltrating lipoma should be excised with surrounding normal muscle and tissue to prevent the recurrence. This case was a 57-year-old female with a painless swelling of the right cervical and parotid areas which was diagnosed as large infiltrating lipoma by clinical examination and radiographic findings. The patient was treated by surgical excision and showed good functional and esthetic results. Histologically the tumor was diagnosed as infiltrating lipoma with no evidence of malignancy.
Extremities ; Female ; Humans ; Lipoma* ; Middle Aged ; Recurrence