Enteropathogenic Escherichia coli (EPEC) have been implicated in human diarrhea in several countries. Central to EPEC-mediated disease is its ability to cause intestinal lesions, known as attaching and effacing (A/E) lesion. We investigated 92 EPEC strains isolated from patients with diarrhea in Gwangju for their genotypic and phenotypic characteristics. Sixteen (17.4%) of all strains were found to be typical EPEC because they were bfpA gene positive by PCR. The most of typical EPEC isolates (87.5%) showed a localized adhesion (LA) pattern in Hep-2 cell adherence assay, whereas, only 11 atypical EPEC isolates (14.5%) were adhered to Hep-2 cells in a localized manner. Thirteen of the EPEC strains studied belonged to classical O-serogroups of EPEC and 7 isolates were classified as nonclassical EPEC serogroup and the other isolates could not be serotyped with our antisera. The subtypes of eae, tir, espA and espB genes which are major virulence genes concerned of A/E lesion on chromosome were analyzed by multiplex PCR for finding the original resource. The results showed that the composition of these genes subtypes was homogenous and heterogenous in 12 and 26 isolates, respectively. The others were non-determined type in terms of the gene subtype because of genetic diversity of intimin-coding eae genes. Our findings indicated that EPEC isolates from patients with diarrhea were diverse genetically and phenotypically, which require further study in regard to their virulence and epidemiological significance.
Diarrhea ; Enteropathogenic Escherichia coli* ; Genetic Variation ; Gwangju* ; Humans ; Immune Sera ; Multiplex Polymerase Chain Reaction ; Polymerase Chain Reaction ; Virulence

No abstract available.
Abscess*

We reviewed our leukemia database to reclassify 610 patients previously diagnosed as having acute myeloid leukemia (AML) according to the updated 2016 WHO classification. Nine patients were categorized as having myelodysplastic syndrome and myeloid neoplasms with germline predisposition. AML with recurrent genetic abnormalities accounted for 57.4% (345/601) of the patients under the 2016 WHO classification. AML with mutated NPM1 was the most common form (16.5%), with the majority associated with monocytic differentiation (63.6%). AML with double CEBPA mutations accounted for 8.3% of these cases, and the majority were previously diagnosed as AML with/without maturation (78.0%). These newly classified mutations were mutually exclusive without overlapping with other forms of AML with recurrent genetic abnormalities. AML with mutated NPM1 and AML with myelodysplasia-related changes comprised the oldest patients, whereas AML with RUNX1-RUNX1T1 included the youngest patients. The leukocyte count was highest in AML with mutated NPM1, and the percentage of peripheral blood blasts was the highest in AML with double CEBPA mutations. Our results indicate that implementation of the 2016 WHO classification of AML would not pose major difficulties in clinical practice. Hematopathologists should review and prepare genetic tests for the new classification, according to their clinical laboratory conditions.
Classification ; Humans ; Leukemia ; Leukemia, Myeloid, Acute ; Leukocyte Count ; Myelodysplastic Syndromes

PURPOSE: Respiratory syncytial virus (RSV) is the major cause of acute lower respiratory tract infection (LRTI) in infants and children. We investigated the association of meteorological conditions and air pollution with the prevalence of RSV infection. METHODS: Between January 2005 and December 2012, a total of 9,113 nasopharyngeal swab specimens from children under 3 years of age who were admitted to the hospital with acute LRTI were tested for RSV antigens using a direct immunofluorescence kit. Meteorological data (mean temperature, precipitation, wind speed, and relative humidity) and air pollutant levels including PM₁₀ (particulate matter with a median aerodynamic diameter less than or equal to 10 µm in diameter), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), and carbon monoxide (CO) in Seoul during the study period were collected from the national monitoring system. The correlations of the monthly incidence of RSV infection with climate factors and air pollutant levels were analyzed. RESULTS: RSV infection mainly occurred between October and February, and showed the peak in November. The prevalence of RSV infection had a moderate negative correlation with mean temperature (r=−0.60, P < 0.001), a weak negative correlation with relative humidity (r=−0.26, P=0.01), and precipitation (r=−0.34, P=0.001). Regarding air pollutants, RSV activity moderately correlated with NO₂ (r=0.40, P < 0.001), SO₂ (r=0.41, P < 0.001), and CO (r=0.58, P < 0.001). In the RSV peak season in Korea (between October and February), RSV epidemics showed a weak positive correlation with relative humidity (r=0.35, P=0.03) and precipitation (r=0.38, P=0.02). CONCLUSION: Meteorological factors and air pollutant levels may be associated with RSV activity. Therefore, further nationwide large-scaled intensive evaluations to prove factors affecting RSV activity are warranted.
Air Pollutants ; Air Pollution* ; Carbon Monoxide ; Child* ; Climate* ; Fluorescent Antibody Technique, Direct ; Humans ; Humidity ; Incidence ; Infant ; Korea ; Meteorological Concepts ; Nitrogen Dioxide ; Prevalence ; Respiratory Syncytial Viruses* ; Respiratory Tract Infections ; Seasons ; Seoul ; Sulfur Dioxide ; Wind

OBJECTIVE: Protocols for posterior circulation ischemic stroke have not been established by randomized clinical trials. Mechanical endovascular thrombectomy (MET) devices are evolving, and many of these devices already developed or in development are suitable for posterior circulation MET. MATERIALS AND METHODS: We investigated the medical records of patients who underwent MET for posterior circulation ischemic stroke from January 2012 to August 2016. Fifteen patients were included. MET was performed in patients with or without injected intravenous tissue plasminogen activator. MET was considered in patients with a National Institute of Health Stroke Scale score of 4 or more, older than 18 years, with definite occlusion of the basilar artery or posterior cerebral artery (PCA), and who arrived at the hospital within 24 hours from onset. RESULTS: The direct catheter aspiration technique was used in five cases, and the stent retrieval technique was used in seven cases. The stent retrieval technique with the direct aspiration technique was used in three cases. Recanalization failed in two cases. Basilar occlusion without PCA involvement is the only effective factor of successful recanalization (p = 0.03). Successful recanalization (p = 0.005) and the presence of a posterior communicating artery (p = 0.005) affected the good outcome at discharge. CONCLUSION: An early diagnosis and active MET may improve the patient outcome. MET may help recanalization and good flow restoration and the potential for a good outcome.
Arteries ; Basilar Artery ; Catheters ; Early Diagnosis ; Humans ; Medical Records ; Passive Cutaneous Anaphylaxis ; Posterior Cerebral Artery* ; Stents ; Stroke ; Thrombectomy* ; Tissue Plasminogen Activator

OBJECTIVE: We introduce innovative method of cervical column reconstruction and performed the reconstruction with a flanged titanium mesh cage (TMC) instead of a plate after anterior corpectomy for cervical spondylotic myelopathy (CSM) and an ossified posterior longitudinal ligament (OPLL).METHODS: Fifty patients with CSM or OPLL who underwent anterior cervical reconstruction with a flanged TMC were investigated retrospectively. Odom’s criteria were used to assess the clinical outcomes. The radiographic evaluation included TMC subsidence, fusion status, and interbody height. Thirty-eight patients underwent single-level and 12 patients underwent two-level corpectomy with a mean follow-up period of 16.8 months.RESULTS: In all, 19 patients (38%) had excellent outcomes and 25 patients (50%) had good outcomes. Two patients (4%) in whom C5 palsy occurred were categorized as poor. The fusion rate at the last follow-up was 98%, and the severe subsidence rate was 34%. No differences in subsidence were observed among Odom’s criteria or between the single-level and two-level corpectomy groups.CONCLUSION: The satisfactory outcomes in this study indicate that the flanged TMC is an effective graft for cervical reconstruction.
Cervical Vertebrae ; Female ; Follow-Up Studies ; Humans ; Longitudinal Ligaments ; Methods ; Ossification of Posterior Longitudinal Ligament ; Paralysis ; Retrospective Studies ; Spinal Cord Diseases ; Spondylosis ; Titanium ; Transplants

Objective: : Spinal cord stimulation (SCS) is an effective treatment for chronic neuropathic pain. However, its clinical efficacy in regard to specific types of pain has not been well studied. The primary objective of this study was to retrospectively analyze the clinical outcomes of paddle-type SCS according to the type of neuropathic pain. Methods: : Seventeen patients who underwent paddle-lead SCS at our hospital were examined. Clinical outcomes were evaluated pre- and postoperatively (3 months, 1 year, and last follow-up) using the Neuropathic Pain Symptom Inventory (NPSI). The NPSI categorizes pain as superficial, deep, paroxysmal, evoked, or dysesthesia and assess the duration of the pain (pain time score). Changes in NPSI scores were compared with change in Visual analogue scale (VAS) scores. Results: : After SCS, the pain time score improved by 45% (independent t-test, p=0.0002) and the deep pain score improved by 58% (independent t-test, p=0.001). Improvements in the pain time score significantly correlated with improvements in the VAS score (r=0.667, p=0.003, Spearman correlation). Additionally, the morphine milligram equivalent value was markedly lower after vs. before surgery (~49 mg, pared t-test, p=0.002). No preoperative value was associated with clinical outcome. Conclusion : The NPSI is a useful tool for evaluating the therapeutic effects of SCS. Chronic use of a paddle-type spinal cord stimulation improved the deep pain and the pain time scores.

Currently, detecting biochemical differences before and after allogeneic stem cell transplantation (SCT) for improved prediction of acute graft-versus-host disease (aGVHD) is a major clinical challenge. In this pilot study, we analyzed the kinetics of circulating adipokine levels in patients with or without aGVHD before and after allogeneic SCT. Serum samples were obtained and stored at -80degrees C within 3 hours after collection, prior to conditioning and at engraftment after transplantation. A protein array system was used to measure the levels of 7 adipokines of patients with aGVHD (n=20) and without aGVHD (n=20). The resistin level at engraftment was significantly increased (p<0.001) after transplantation, regardless of aGVHD occurrence. In the non-aGVHD group, the concentrations of the hepatocyte growth factor (HGF) (mean values+/-SD; 206.6+/-34.3 vs. 432.3+/-108.9 pg/ml, p=0.040) and angiopoietin-2 (ANG-2) (mean values+/-SD; 3,197.2+/-328.3 vs. 4,471.8+/-568.4 pg/ml, p=0.037) at engraftment were significantly higher than those of the pre-transplant period, whereas in the aGVHD group, the levels of adipokines did not change after transplantation. Our study suggests that changes in serum HGF and ANG-2 levels could be considered helpful markers for the subsequent occurrence of aGVHD.
Adipokines* ; Angiopoietin-2 ; Graft vs Host Disease* ; Hepatocyte Growth Factor ; Humans ; Kinetics ; Pilot Projects ; Protein Array Analysis ; Resistin ; Stem Cell Transplantation

PURPOSE: Prenatal environmental conditions affect the development of the fetus. In the present study, we investigated the effects of exposure to music and noise during pregnancy on neurogenesis and thickness in the motor and somatosensory cortex of rat pups. METHODS: The pregnant rats in the music-applied group were exposed to 65 dB of comfortable music for 1 hour, once per day, from the 15th day of pregnancy until delivery. The pregnant rats in the noise-applied group were exposed to 95 dB of sound from a supersonic sound machine for 1 hour, once per day, from the 15th day of pregnancy until delivery. After birth, the offspring were left undisturbed together with their mother. The rat pups were sacrificed at 21 days after birth. RESULTS: Exposure to music during pregnancy increased neurogenesis in the motor and somatosensory cortex of rat pups. In contrast, rat pups exposed to noise during pregnancy showed decreased neurogenesis and thickness in the motor and somatosensory cortex. CONCLUSIONS: Our study suggests that music and noise during the developmental period are important factors influencing brain development and urogenital disorders.
Animals ; Brain ; Fetus ; Humans ; Mothers ; Motor Cortex ; Music ; Neurogenesis ; Noise ; Parturition ; Pregnancy ; Rats ; Somatosensory Cortex

Hepatitis E is an infectious viral disease with clinical and morphologic features of acute hepatitis. Although HEV infection is endemic in the Indian subcontinent, Southeast and Central Asia, a large outbreak of hepatitis E was identified in China. Smaller outbreaks have been observed in the Middle East, northern and western parts of Africa, and Mexico. Sporadic hepatitis E also has been observed in several countries. In nonendemic regions, the sporadic cases of hepatitis E are almost always associated with travel to HEV-endemic regions. In Korea, there has been no report on hepatitis E. Recently, we experienced a case of acute icteric hepatitis in which serologic study showed seroconversion of IgM anti-HEV. The patient did not have any travel history to an HEV-endemic area. We report this as an initial case of acute hepatitis E in Korea.
Acute Disease ; Adult ; English Abstract ; *Hepatitis E/diagnosis/epidemiology ; Human ; Korea/epidemiology ; Male