The 56-kilodalton protein genes of Orientia tsutsugamushi TA678, TA686, TA716, TA763 strains were amplified by PCR. The amplified products were sequenced and cloned into pIH821 vector. The recombinant proteins were expressed in Escherichia coli as fusion proteins with maltose binding protein. The recombinant proteins were purified and used for the sensitization of sheep RBCs and the reactivity of the recombinant 56-kDa proteins of Orientia tsutsugamushi TA 678, TA686, TA716 strains were analyzed with 40 sera from scrub typhus patients in Korea, 40 sera from scrub typhus in Thailand, Malaysia and Philippines. The 56-kDa protein coding DNA sequence of Orientia tsutsugamushi TA678, TA686, TA716 show 70 to 88% homology with other known strains and four variable regions are also observed. 39 of 40 sera from scrub typhus patients in Korea showed the strongest reactivity to the recombinant protein of Boryong strain and one sera showed the strongest reactivity to the recombinant protein of Gilliam strain. 14 of 40 sera from patients in Thailand, Malaysia and Philippines showed the strongest reactivity to the recombinant protein of TA686 strain and 12 sera showed the strongest reactivity to the recombinant protein of TA716 strain. No serum from patients in Thailand, Malaysia and Philippines showed the strongest reactivity to the recombinant protein of Boryong strain.
Asian Continental Ancestry Group* ; Base Sequence ; Chungcheongnam-do ; Clinical Coding ; Clone Cells ; Cloning, Molecular* ; Escherichia coli ; Hemagglutination Tests* ; Hemagglutination* ; Humans ; Korea ; Malaysia ; Maltose-Binding Proteins ; Orientia tsutsugamushi* ; Philippines ; Polymerase Chain Reaction ; Recombinant Proteins ; Scrub Typhus ; Sheep ; Thailand

PURPOSE:To report a case of ocular decompression retinopathy after resolution of acute primary angle closure (APAC) subsequent to medical treatment and laser peripheral iridotomy (LPI). CASE SUMMARY: A patient presented with APAC of the right eye with markedly elevated intraocular pressure (IOP) and a LPI was done after lowering the IOP with medical treatment. On presentation, visual acuity was 0.3 in the right eye (OD) and IOP was 74 mmHg OD. Two hours after medical treatment IOP was found to be 16 mmHg OD. Ten hours after resolution of the acute attack, the patient's visual acuity was 0.2 OD and IOP was 11 mmHg OD. LPI was subsequently performed in the right eye. The post-LPI IOP was 10 mmHg and the patient complained of visual disturbance and floaters OD. Three days after LPI the IOP was normal but her visual acuity had decreased to counting fingers OD. In addition, scattered retinal hemorrhages including alarge pre-retinal hemorrhage on the macula were found upon dilated funduscopic examination. After three months the retinal hemorrhage had been absorbed and her visual acuity was 0.7 OD. CONCLUSIONS: Decompression retinopathy can develop in the posterior pole of the retina in patients with APAC after medical treatment and LPI.
Decompression ; Eye ; Fingers ; Glaucoma, Angle-Closure ; Hemorrhage ; Humans ; Intraocular Pressure ; Retina ; Retinal Hemorrhage ; Visual Acuity

No abstract available.
Hospitals, Community* ; Humans

The purpose of this study is to identify a group of mild head injury patients having lesions on computerized tomography(CT) and to investigate the risk factors affecting the abnormal findings on CT scan. The study was limited to patients 16 years of age and older with a initial Glasgow Coma Scale(GCS) scores of at least 13 at the time of admission. Of a total of 243 patients studied, 156(64.2%) had abnormal CT findings. 49 patients(20.2%) required neurosurgical intervention(craniotomies for hematoma in 33, hematoma in 1 and subdural hygroma in 3). Four patients(2.4%) died of their cranial injury and three died of extracranial causes. The incidence of CT abnormalities for each GCS score was 86.7% in GCS of 13, 68.6% in GCS of 14, and 58.6% in GCS of 5. The factors affecting GCS scores at the time of admission were the presence of loss of consciousness and posttraumatic amnesia. The factors affecting abnormal CT scans were the presence of posttraumatic amnesia and skull fracture. A new lesion of extension of the initial finding on follow-up CT scans was found in 9.3% of 75 patients who underwent follow-up CT scans. Even though routine CT scans for mild head injury patients are not always necessary, these result suggest that all patients admitted to hospital after mild head injury should undergo CT scanning to enable early detection of an intracranial lesion.
Amnesia ; Coma ; Craniocerebral Trauma* ; Follow-Up Studies ; Glasgow Coma Scale ; Head* ; Hematoma ; Humans ; Incidence ; Risk Factors ; Skull Fractures ; Subdural Effusion ; Tomography, X-Ray Computed* ; Unconsciousness

Background: Non-HLA antibodies, anti-angiotensin II type 1 receptor antibodies (anti-AT1R) and anti-endothelial cell antibodies (AECA), are known to play a role in allograft rejection. We evaluated the role of both antibodies in predicting post-transplant outcomes in low-risk living donor kidney transplantation (LDKT) recipients. Methods: In 94 consecutive LDKT recipients who were ABO compatible and negative for pre-transplant HLA donor-specific antibodies, we determined the levels of anti-AT1Rs using an enzyme-linked immunosorbent assay and the presence of AECAs using a flow cytometric endothelial cell crossmatch (ECXM) assay with pre-transplant sera. Hazard ratio (HR) was calculated to predict post-transplant outcomes. Results: Pre-transplant anti-AT1Rs (≥11.5 U/mL) and AECAs were observed in 36 (38.3%) and 22 recipients (23.4%), respectively; 11 recipients had both. Pre-transplant anti-AT1Rs were a significant risk factor for the development of acute rejection (AR) (HR 2.09; P=0.018), while a positive AECA status was associated with AR or microvascular inflammation only (HR 2.47; P=0.004) throughout the follow-up period. In particular, AECA (+) recipients with ≥11.5 U/mL anti-AT1Rs exhibited a significant effect on creatinine and estimated glomerular filtration rate (P<0.001; P=0.028), although the risk of AR was not significant. Conclusions Pre-transplant anti-AT1Rs and AECAs have independent negative effects on post-transplant outcomes in low-risk LDKT recipients. Assessment of both antibodies would be helpful in stratifying the pre-transplant immunological risk, even in low-risk LDKT recipients.

We report a case of ventriculoureteral shunt to reise malfunctioning ventriculoperitoneal shunt in a 30-year-old man. The patient had 4 times recurrent pseudocyst filled with cerebrospinal fluid caused by complications at the distal end of the abdominal catheter. The presence of an abdominal pseudocyst can be detected by performing an ultrasound examination of the abdomen. We shall describe the operative technique of the ventriculoureteral shunt procedure without nephrectomy by reimplantation of the ureter and a psoas hitch.
Abdomen ; Adult ; Catheters ; Cerebrospinal Fluid ; Humans ; Nephrectomy ; Replantation ; Ultrasonography ; Ureter ; Ventriculoperitoneal Shunt*

To understand the seroepidemiological patterns of haemorrhagic fever with renal syndrome in Korea, a nation-wide survey collaborated with fourteen clinics was carried out from 1994 to 1996. Sera of 4,547 patients with acute febrile episodes were tested by indirect immunofluorescent antibody test and the seroepidemiological analysis including sex, age, seasonal and regional distributions were performed. According to the results obtained in this study, the epidemiological characteristics of haemorrhagic fever with renal syndrome in Korea were summarized as follows: 1. Seropositive rate of hemorrhagic fever with renal syndrome among the patients with acute febrile episodes was 6.4% by the cut-off point of 1:40. 2. Among the seropositives, male outnumbered female and the ratio of males to females was 2.0:1.0. 3. Seventy six % of the seropositive patients were 21-60 years old. 4. The number of seropositive cases increased from October and reached maximum in December and began to decrease gradually from January. 5. The geographical distribution of the seropositives cover most areas including Cheju province in Korea.
Female ; Fever ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Jeju-do ; Korea* ; Male ; Seasons

Acute eosinophilic pneumonia is one of a recently described idiopathic eosinophilic lung disease, which differs from chronic eosinophilic pneumonia. Patients with acute eosinophilic pneumonia develop acute onset of dyspnea, hypoxemia, diffuse pulmonary infiltrates and pleural effusion on chest radiograph, and show an increase in number of eosinophils in bronchoalveolar lavage fluid or lung biopsy specimen. Prompt and complete response to corticosteroid therapy without any recurrence is characteristically seen in patient with this disease. Although the etiology of acute eosinophilic pneumonia is not known, it has been suggested to be related to a hypersensitivity phenomenon to an unidentified inhaled antigen. We report four cases of acute eosinophilic pneumonia presented with acute onset of dyspnea, diffuse pulmonary infiltrates on chest radiograph, and eosinophilia in bronchoalveolar lavage.'luid in previously healthy adults.
Adult ; Anoxia ; Biopsy ; Bronchoalveolar Lavage Fluid ; Dyspnea ; Eosinophilia ; Eosinophils* ; Humans ; Hypersensitivity ; Lung ; Lung Diseases ; Pleural Effusion ; Pulmonary Eosinophilia* ; Radiography, Thoracic ; Recurrence

Acute eosinophilic pneumonia is one of a recently described idiopathic eosinophilic lung disease, which differs from chronic eosinophilic pneumonia. Patients with acute eosinophilic pneumonia develop acute onset of dyspnea, hypoxemia, diffuse pulmonary infiltrates and pleural effusion on chest radiograph, and show an increase in number of eosinophils in bronchoalveolar lavage fluid or lung biopsy specimen. Prompt and complete response to corticosteroid therapy without any recurrence is characteristically seen in patient with this disease. Although the etiology of acute eosinophilic pneumonia is not known, it has been suggested to be related to a hypersensitivity phenomenon to an unidentified inhaled antigen. We report four cases of acute eosinophilic pneumonia presented with acute onset of dyspnea, diffuse pulmonary infiltrates on chest radiograph, and eosinophilia in bronchoalveolar lavage.'luid in previously healthy adults.
Adult ; Anoxia ; Biopsy ; Bronchoalveolar Lavage Fluid ; Dyspnea ; Eosinophilia ; Eosinophils* ; Humans ; Hypersensitivity ; Lung ; Lung Diseases ; Pleural Effusion ; Pulmonary Eosinophilia* ; Radiography, Thoracic ; Recurrence