BACKGROUND: CMV Antigenemia (CMV-Ag) assay and polymerase chain reaction (PCR) have been introduced as exponents of a new generation of tests for the detection of CMV infection. So we compared Roche Amplicor test with CMV-Ag assay to evaluate their clinical usefulness. METHODS: CMV-Ag assay using CMV-vueTM kit (INCSTAR Co., U.S.A.) detects pp65 antigen in leukocytes by immunoperoxidase detection system (positive; stained nucleus > OR =1). Amplicor CMV test (Roche Diagnostic Systems, Inc., Branching, NJ, USA) using plasma or serum is based on PCR amplification of target DNA using CMV specific biotinylated primer and hybridization of the amplified products to the probe and subsequent colorimetric detection of amplified DNA. RESULTS: Of the bone marrow transplanted 73 cases, eleven cases showed discrepancy between the two methods. Of these 10 cases those showed positive results only by Amplicor CMV test, 9 cases turned out to be true positive by the follow-up test and clinical manifestation. And the remaining one case was thought to be false positive. One case which showed positive result only by CMV-Ag assay was proved to be true positive. Consequently, CMV-Ag assay had sensitivity of 73.5% and specificity of 100%, Amplicor CMV test had 97.1% and 97.4%, respectively. Amplicor CMV test detected CMV DNA average 16.3 days before the onset of clinical manifestation and sustained until 10 days after symptoms disappearance, otherwise CMV-Ag assay detected mean 3.8 days earlier and sustained 4.2 days after. CONCLUSIONS: Amplicor CMV test is more sensitive, rapid and longer sustained method than CMV-Ag assay but it lacks quantitation.
Bone Marrow* ; Cytomegalovirus Infections* ; Cytomegalovirus* ; DNA ; Follow-Up Studies ; Leukocytes ; Plasma ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Transplantation*

BACKGROUND/AIMS: Sleep disorder (SD) is associated with an increased risk of cardiovascular disease and is more prevalent among individuals with type 2 diabetes mellitus. These health problems not only frequently coexist but also exacerbate each other. We conducted a cross-sectional study to estimate the prevalence of SD among diabetic patients and to investigate the relationship between SD and cardiovascular risk among these patients. METHODS: We recruited 784 patients with type 2 diabetes and conducted a self-administered questionnaire. We assessed sleep quality using the Pittsburgh Sleep Quality Index and the risk of obstructive sleep apnea (OSA) using the Berlin Questionnaire. Additional information included blood pressure and metabolic profiles. RESULTS: Of the 784 diabetic patients, 301 (38.4%) patients had poor sleep quality, and 124 (15.8%) were at high risk for OSA. Patients at increased risk for OSA were more obese; they also had higher blood pressure, fasting plasma insulin levels, insulin resistance assessed by homeostasis model assessment (HOMA-IR), and serum triglycerides levels (p < 0.05). The frequency of risk for OSA was higher among obese patients compared with non-obese patients (34.8% vs. 9.4%, p < 0.05). Logistic regression analysis revealed that male sex and bone mass index were independent predictors of risk for OSA. CONCLUSIONS: SD was prevalent among type 2 diabetic patients, and OSA could aggravate their risk for cardiovascular disease. Clinical treatment of these patients should include evaluation and intervention for SD.
Adult ; Aged ; Analysis of Variance ; Body Mass Index ; Cardiovascular Diseases/*epidemiology ; Chi-Square Distribution ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/*epidemiology ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Obesity/epidemiology ; Prevalence ; Questionnaires ; Republic of Korea/epidemiology ; Risk Assessment ; Risk Factors ; Sex Factors ; Sleep Apnea, Obstructive/epidemiology ; Sleep Disorders/diagnosis/*epidemiology

BACKGROUND AND OBJECTIVE: Atopic dermatitis(AD) is a chronic inflammatory skin disease with a high incidence in early childhood. Staphylococcus aureus(SA) is found at high concentrations in over 90% of AD skin lesions compared with 5-37% of age-matched controls. SA isolates from AD subjects have a high prevalence(37-57%) of superantigen-producing strains. And staphylococcal enterotoxin B(SEB) has been shown to induce inflammatory reactions following application to intact skin of normal and atopic subjects. These findings suggest that SA toxin produced by SA may be linked with initiation or aggravation of AD, but the role of satphylococcal enterotoxin to the T cell in the pathogenesis of AD has not been determined clearly. This study was conducted to determine whether staphylococcal enterotoxin might have a role as a superantigen in the pathogenesis of AD. Materials and Method: We investigated the proliferative responses of peripheral blood mononuclear cell(PBMC) from 8 patients with AD and 10 age-matched normal controls. We also assessed T cell markers and T cell receptor(TCR) Vbeta chain expression by flow cytometry with and without SEB stimulation. RESULTS: PBMC from AD patients showed increased proliferation to SEB 100 pg/ml and 1000 pg/ml compared to controls. There were no differences of CD3(+), CD4(+), and CD8(+) cells after SEB stimulation between the two groups. And there were also no differences of TCR Vbeta2(+) and TCR Vbeta8(+) cells with and without SEB stimulation, but TCR Vbeta17(+) cells were increased after SEB stimulation not only in AD patients but also in controls compared to culture without SEB. The expressions of TCR Vbeta17 chain of CD3(+) and CD4(+) cells after SEB stimulation were increased in AD patients compared to controls. Furthermore, there was positive correlation between the enhanced PBMC proliferative responses to SEB and increased expressions of SEB reactive TCR Vbeta17(+)/CD4(+) cells in AD patients and controls. CONCLUSION: These findings suggest that SEB is important in the pathogenesis of atopic dermatitis and also provide evidence that the increased use of certain TCR Vbeta families is of functional significance.
Dermatitis, Atopic* ; Enterotoxins* ; Flow Cytometry ; Humans ; Incidence ; Skin ; Skin Diseases ; Staphylococcus

BACKGROUND: Enterobacter species are frequent nosocomial pathogens and the proportion of beta-lactam resistant strains are on the increase. Extended spectrum beta-lactamases(ESBLs) were mainly investigated in Klebsiella pneumoniae and Escherichia coli in Korea. Recently, we experienced 4 strains of multidrug(including cephamycin)-resistant Enterobacter cloacae and characterized the ESBL types. METHODS: Multidrug-resistant E. cloacae strains were tested for ESBL production by double-disk synergy test and conjugation. The presence of TEM, SHV or IMP gene was determined by polymerase chain reaction. RESULTS: Of the four strains that revealed positive reaction in double-disk synergy test, ceftazidime- resistance was transferred in two and cefoxitin-resistance was transferred in four strains by conjugation. In the polymerase chain reaction, three out of four strains had both TEM and SHV genes and one strain had only TEM gene. Two ceftazidime transconjugants had both TEM and SHV genes. CONCLUSION: We should be aware of ESBL producing Enterobacteriaceae and the possible institutional spread of resistance genes.
beta-Lactams* ; Ceftazidime ; Cloaca ; Drug Resistance, Multiple ; Enterobacter cloacae* ; Enterobacter* ; Enterobacteriaceae ; Escherichia coli ; Klebsiella pneumoniae ; Korea ; Plasmids ; Polymerase Chain Reaction

Progressive multifocal leukoencephalopathy (PML) is a rare, serious, and usually fatal demyelinating disease that occurs predominantly in severely immunosuppressed patients. The disease is caused by the infection of oligodendrocytes with JC virus that is widely distributed as a latent infection in the general populations. PML has been described mainly in patients infected with the human immunodeficiency virus. However, other immune-suppressed patients including malignancies and organ transplants can be affected with JC virus infection. Recently it is suggested that rheumatologic diseases, including systemic lupus erythematosus (SLE), rheumatoid arthritis, dermatomyositis, polymyositis, wegener`s granulomatosis be known to be at risk of developing PML. We report a case of PML in a patient with SLE.
Humans

BACKGROUND: Long menstrual cycle is a risk factor for developing type 2 diabetes and cardiovascular disease in women. We aimed to evaluate the association between existing type 2 diabetes and oligomenorrhea before diagnosis of diabetes, and to observe the differences in this association among obese and non-obese Korean women. METHODS: Patients with type 2 diabetes (n=118) and without any clinical evidence of abnormal glucose regulation (n=258) who attended the outpatient clinic of a university hospital and were over age 30. Patients self-reporting a menstrual cycle over 40 days during their 20s were defined as oligomenorrhea before diagnosis of diabetes. Obesity was defined as having a body mass index (BMI) over 25 kg/m2. RESULTS: The frequency of oligomenorrhea before diagnosis of diabetes was almost two-fold higher in women with type 2 diabetes than in the control group (16.1% vs. 8.5%, P=0.03). Oligomenorrhea was associated with type 2 diabetes after adjusting for age, BMI, systolic blood pressure, triglycerides, and high density lipoprotein cholesterol (odds ratio, 3.89; 95% confidence interval, 1.37 to 11.04). Among women with oligomenorrhea before diagnosis of diabetes, the frequency of type 2 diabetes was significantly higher in obese subjects than in their non-obese counterparts (90.9% vs. 30.0%, P=0.03). CONCLUSION: Having a long menstrual cycle could be a risk factor for the development of type 2 diabetes, especially in obese women.
Ambulatory Care Facilities ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Female ; Glucose ; Humans ; Lipoproteins ; Menstrual Cycle ; Obesity ; Oligomenorrhea ; Risk Factors ; Triglycerides

Leiomyoma and adenomyosis of the uterus are the most common gynecologic disorders in an enlarged uterus. The characteristic US and MR findings in differentiation between both lesions were prospectively evaluated in 30 patients. Of 30 patients, 15 were leiomyomas, 6 were adenomyosises, 8 were leiomyomas and adenomyosises, and 1 was a normal pregnancy, histologically. The total number of leiomyom nodules were 49 while adenomyosises were 14 (9 diffuse and 5 focal). Among 49 myomas nodules, 36 were correctly diagnosed by sonography. The characteristic US findings of uterine leiomyoma were well defined nodules (36), hypoechoic peripheral rim (16), and whorl-like internal echoes (13). Forty four of the 49 myoma nodules were correctly diagnosed by MRI. The characteristic MR findings of myoma were well defined nodules (43), peripheral low signal intensity rim on T1WI (13) and T2WI (9), and peripheral high signal intensity rim on T2WI (5). Among 14 adenomyosises, 9 were correctly diagnosed by sonography. The characteristic US findings of adenomyosis were diffuse uterine hypertrophy more than 5.5cm in AP diameter with endometrial displacement and no significant echo change in myometrium All 14 adenomyosis as were correctly diagnosed from MRI. On T2WI, adenomyosis appeared as ill defined localized or diffuse thickening of the junctional zone more than 1cm in thickness. It was our conclusion that to differentiate between leiomyoma and adenomyosis focused on should be the detection of existence of nodule in leiomyoma, the primary sign, not on the secondary indirect sign.
Adenomyosis* ; Animals ; Female ; Humans ; Hypertrophy ; Leiomyoma* ; Magnetic Resonance Imaging ; Mice ; Myoma ; Myometrium ; Pregnancy ; Prospective Studies ; Uterus

We investigated the impact of vitamin D3 (VD3) supplementation during mouse preantral follicle culture in vitro and the mRNA expression of 25-hydroxylase (CYP2R1), 1-alpha-hydroxylase (CYP27B1), and vitamin D receptor (VDR) in mouse ovarian follicles at different stages. Methods: Preantral follicles were retrieved from 39 BDF1 mice (7–8 weeks old) and then cultured in vitro for 12 days under VD3 supplementation (0, 25, and 50 pg/mL). Follicular development and the final oocyte acquisition were assessed. Preantral follicles were retrieved from 15 other BDF1 mice (7–8 weeks old) and cultured without VD3 supplementation. Three stages of mouse ovarian follicles were obtained (preantral, antral, and ruptured follicles). Total RNA was extracted from the pooled cells (from 20 follicles at each stage), and then reverse transcriptase-polymerase chain reaction was performed to identify mRNA for CYP2R1, CYP27B1, and VDR. Results: The survival of preantral follicles, rates of antrum formation and ruptured follicles (per initiated follicle) and the number of total or mature oocytes were all comparable among the three groups. Both CYP2R1 and CYP27B1 were expressed in antral and ruptured follicles, but not in preantral follicles. VDR was expressed in all three follicular stages. Conclusion: VD3 supplementation in vitro (25 or 50 pg/mL) did not enhance mouse follicular development or final oocyte acquisition. Follicular stage-specific expression of CYP2R1, CYP27B1, and VDR was observed.

Methods: We selected 210 fresh IVF cycles performed in 170 infertile women at a single center from January 2014 to November 2019. Four to 14 (total) oocytes were obtained in all cycles after conventional ovarian stimulation. A receiver operating characteristic curve analysis was performed to find the moderate and extreme cutoff numbers of mature oocytes that would produce ≥1, ≥2, ≥3, ≥4, and ≥5 top-quality embryos. Results: The cutoff number of mature oocytes was significantly correlated with the number of top-quality embryos (r =0.467, p =0.000). The moderate cutoff number of mature oocytes was ≥3, ≥5, ≥5, ≥6, and ≥6 for obtaining ≥1, ≥2, ≥3, ≥4, and ≥5 top-quality embryos, respectively. The extreme cutoff number of mature oocytes was ≥9, ≥9, ≥10, ≥10, and ≥11 for obtaining ≥1, ≥2, ≥3, ≥4, and ≥5 top-quality embryos, respectively. Conclusion We present the optimal cutoff numbers of mature oocytes that would yield ≥1, ≥2, ≥3, ≥4, and ≥5 top-quality embryos with 95% specificity. Our findings could help infertility clinicians to set target mature oocyte numbers in women undergoing stimulated IVF cycles.

We report on a de novo centric fission of chromosome 11 in a healthy female referred for chromosome analysis due to recurrent miscarriages. Both fission products were mitotically stable. This centric fission of chromosome 11 appears to have no clinical significance for this patient other than recurrent miscarriages.
Humans ; Female ; *Chromosomes, Human, Pair 11 ; *Chromosome Aberrations ; Adult ; Abortion, Habitual/*genetics