29 isoniazid (INH) resistant isolated strains and INH sensitive reference strain (H37Rv) of Mycobacterium tuberculosis were analysed by polymerase chain reaction-single strand conformational polymorphism (PCR-SSCP) and NciI restriction mapping for the detection of mutations in katG gene and inhA gene. The katG gene was divided into 3 parts (Akat, Bkat, Ckat; each part is about 800 bp) and amplified, inhA gene was amplified as a whole. Each of the amplified 800 bp DNA was digested into small fragments of less than 400 bp with restriction enzymes for the direct PCR-SSCP analysis. Firstly, 10 strains were analysed. All the 10 isolates showed clearly distinct SSCP patterns in Bkat from that of the reference strain, but only two isolates showed distinct SSCP patterns in Akat, and no isolated strain showed any distinct SSCP patterns in Ckat. 10 isolates also showed distinct SSCP patterns in inhA. NciI restriction mapping of Bkat showed mutation in codon 463 in 7 strains among 10 isolated strains. With these results an early detection strategy for the INH resistant M. tuberculosis was applied to the rest of 19 isolated INH resistant strains. Firstly, isolates were screened by Ncsl mapping in Bkat, and 13 strains showed mutations in codon 463. Secondly, the rest of 6 INH resistant isolates were analysed by PCR-SSCP with restriction enzyme digestion (PCR-SSCP-RE) in Bkat, and all the strains showed distinct SSCP patterns from that of the INH sensitive reference strain. This proved our strategy as effective and economic and time saving method in early detection of INH resistant M. tuberculosis.
Codon ; Diagnosis* ; Digestion ; DNA ; Isoniazid* ; Korea* ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymorphism, Single-Stranded Conformational ; Restriction Mapping ; Tuberculosis

Primary malignant parovarian epithelial tumors are extremely rare, with only 56 cases previously reported in the world literature. Most parovarian epithelial tumors are of paramesonephric (Mullerian) origin. In this article, we report the first case in the Korean literature of papillary serous cystadenoma of borderline malignancy from paramesonephric parovarian cyst. This case presented here is of particular interest since this neoplasm is rare. A 48-year-old female underwent a hysterectomy with bilateral adnexectomy and pelvic lymph node dissection for a cystic tumor of the right parovarian area. The tumor, measuring 13 cm in diameter, was apart from the ovaries, fallopian tubes and uterus. The cyst wall had well-developed smooth muscle layers. The cyst was lined with mildly atypical ciliated and non-ciliated low columnar cells compatible with those of paramesonephric origin. From the inner surface of the cyst several cauliflower-like structures projected into the lumen. They were of a predominantly papillary architecture covered by atypical epithelial cells with piling-up and occasional glandular growth. No destructive stromal invasion was identified.
Cystadenoma, Serous* ; Epithelial Cells ; Fallopian Tubes ; Female ; Humans ; Hysterectomy ; Lymph Node Excision ; Middle Aged ; Muscle, Smooth ; Ovary ; Parovarian Cyst* ; Uterus

BACKGROUND: Motor conduction slowing in diabetic distal symmetrical polyneuropathy (DSP) generally exceeds that in distal axonal polyneuropathy. Additional mechanisms secondary to axonal injury may contribute towards this slowing. However, clinical and pathophysiological significances of motor conduction slowing have been rarely discussed. The purpose of this study is to evaluate the clinical and pathophysiological significance of conduction slowing in DSP. METHODS: We analyzed motor conduction studies of 39 patients with symptomatic painful DSP and 24 patients with asymptomatic painless DSP. Motor conduction studies of 39 patients with amyotrophic lateral sclerosis (ALS) were used as controls for the amplitude-dependent slowing of conduction. Percentages of normal limits were calculated for the compound muscle action potential amplitude (CMAP), distal motor latency (DL), and conduction velocity (CV), and converted to a square root (SQRT) form. The changes of SQRT-DL or SQRT-CV according to SQRT-CMAP changes were plotted and analyzed. RESULTS: Regression analysis showed that DL and CV were amplitude-dependent in both painless DSP and ALS. The changes of DL and CV in painful DSP did not show amplitude-dependency except DL in the lower extremities. CONCLUSIONS: This data supports the hypothesis that the mechanism of slowing is similar in both painless DSP and ALS and results from the loss of large, fast-conducting fibers. Lack of amplitude-dependency of conduction slowing in painful DSP may reflect the combined axonal and demyelinating changes, possibly due to inflammation.
Action Potentials ; Amyotrophic Lateral Sclerosis ; Axons ; Diabetic Neuropathies* ; Electrophysiology ; Humans ; Inflammation ; Lower Extremity ; Neural Conduction ; Polyneuropathies

BACKGROUND: Xpert Flu (Cepheid, USA) allows for fully automated real-time RT-PCR using a single-use disposable cartridge. The aim of this study was to evaluate Xpert Flu for the detection of influenza A virus and subtype A/H1N1/2009 pandemic virus. METHODS: We conducted a prospective comparison study for Xpert Flu with the RealTime ready Influenza A/H1N1 Detection Set (Roche Diagnostics, Germany). Analytical specificities of the assays were determined by testing commonly encountered respiratory viral pathogens, including parainfluenza virus type 1/2/3, rhinovirus A, rhinovirus B, metapneumovirus, adenovirus, and coronavirus. The analytical sensitivities and workflow of both methods were also assessed. RESULTS: A total of 102 consecutive clinical specimens were tested by both methods. Total agreement between the two methods was estimated to be 99.0% (101/102): 11 A/H1N1/2009 and 3 seasonal influenza A by the RealTime ready Influenza A/H1N1 Detection Set; 10 and 3 by Xpert Flu. No cross-reactivity was observed between influenza A/H1N1/2009 and other respiratory viral pathogens in either method. The limits of detection of the RealTime ready Influenza A/H1N1 Detection Set and Xpert Flu were 500 TCID50/mL and 20 TCID50/mL, respectively. Xpert Flu required 85 minutes (10 minutes of hands-on time) for processing, while RealTime ready Influenza A/H1N1 Detection Set took 128 minutes (30 minutes of handson time). CONCLUSION: The results of Xpert Flu were comparable to those of the RealTime ready Influenza A/H1N1 Detection Set. It is of note that the fully automated and closed system of Xpert Flu could be advantageous for reducing hands-on time and for preventing cross-contamination during the testing process.
Adenoviridae ; Coronavirus ; Influenza A virus ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; Limit of Detection ; Metapneumovirus ; Pandemics ; Paramyxoviridae Infections ; Prospective Studies ; Rhinovirus ; Seasons ; Sprains and Strains ; Viruses

Tomb with lime-soil mixture barrier (LSMB) was constructed by the people from upper class people of Joseon Dynasty. The coffin of LSMB was surrounded by hard concrete barriers, being successfully protected from outside invasions until the archaeological excavation begins. The human remains were extremely preserved well, providing important information on the health and illness of the people of Joseon dynasty. Recent investigation into human skeletons from LSMB in Yong-in city was another forensic anthropological case that was very meaningful to our research. During the examination on the elderly Joseon female bones, we discovered unusual saw-marks on the shaft of both tibiae. We could not find any osteological evidences suggestive of healed bone process. Considering archaeological and anthropological findings altogether, the occurrence time of saw-marks was considered to be perimortem period. However, as for why such a saw mark was made on the tibiae, we did not get any information about it. We expect that this report facilitate other researcher to do explore the usefulness of forensic anthropology examination on the similar human skeleton cases identified in various archaeological ruins.
Aged ; Female ; Forensic Anthropology ; Gyeonggi-do ; Humans ; Skeleton* ; Tibia*

Omental pregnancy is an extremely rare form of abdominal pregnancy that may cause life threatening massive hemorrhage in case of rupture. It may occur by primary implantation of the fertilized ovum in the omentum. The diagnosis is very difficult, but prompt surgical intervention is required when it is suspected, because perinatal mortality and maternal mortality in abdominal pregnancy were 85~95% and 0.5~6%. We experienced a case of omental pregnancy in the first times and reported it with brief review of literature.
Diagnosis ; Female ; Hemorrhage ; Maternal Mortality ; Omentum ; Perinatal Mortality ; Pregnancy* ; Pregnancy, Abdominal ; Rupture ; Zygote

Gestational trophoblastic tumor became one of the curable disease due to the development of chemotherapy, appropriate follow up of beta- human chorionic gonadotropin and others. But metastatic trophoblastic tumor still shows high mortality rate because of resistance to the chemotherapy and large tumor burden.One of the important prognostic factors determining the prognosis of gestational trophoblastic tumor is antecedent pregnancy, which affects the response to therapy. Choriocarcinoma following term pregnancy is rare one with the incidence of one per 160,000 pregnancies in United States and the prognosis is poor because of late diagnosis and combined high risk prognostic factors.We present a choriocarcinoma following term pregnancy that required emergency total abdominal hysterectomy due to profuse bleeding with brief review of literatures.
Choriocarcinoma* ; Chorionic Gonadotropin ; Delayed Diagnosis ; Drug Therapy ; Emergencies ; Female ; Follow-Up Studies ; Hemorrhage ; Hysterectomy ; Incidence ; Mortality ; Pregnancy ; Pregnancy* ; Prognosis ; Trophoblastic Neoplasms ; United States

Acute generalized exanthematous pustulosis(AGEP) is a disease entity caused mostly by drugs or viral infections. Clinically, it manifests as generalized erythema and tiny pustules with fever, but may manifest targetoid lesions, purpura, edema, blisters and mucosal erosions in addition to pustules. We describe a case of AGEP with erythema multiforme-like features in a 46 year old woman who presented with acute onset of high fever and a noticeably polymorphic eruption consisting of numerous tiny pustules on erythematous bases, edematous targetoid lesions and purpuric lesions. The histology revealed subcorneal neutrophilic pustules on the tiny pustular lesions and markedly papillary dermal edema on the erythema multiforme-like lesions. Systemic corticosteroid and antihistamines were initiated, resulting in rapid resolution without recurrence.
Acute Generalized Exanthematous Pustulosis* ; Blister ; Edema ; Erythema* ; Female ; Fever ; Histamine Antagonists ; Humans ; Middle Aged ; Neutrophils ; Purpura ; Recurrence

The genetic status of cagA, vacA subtype, iceA1, and babA, and the relationship to gastroduodenal diseases were assessed in Helicobacter pylori isolates in Korea. Seventy-six strains of H. pylori were isolated from the antrum and the corpus of 41 adult patients (22 with peptic ulcer and 19 with gastritis). The cagA, iceA1, and babA genes were assessed by polymerase chain reaction and the vacA subtypes were determined by reverse hybridization-line probe assay. The positive rates of 349-bp cagA, 208-bp cagA, iceA1, and babA genes were 97.4%, 96.1%, 84.2%, and 36.1%, respectively. The vacA s1a, s1b, s1c, and s2 variants were detected in 11.8%, 3.9%, 80.4%, and 1.3%, respectively. m1 (78.9%) is more prevalent than m2 (5.3%). The most common vacA genotype was s1c/m1 (61.9%), and 14 isolates (18.4%) contained mixed vacA genotypes from a single biopsy specimen. Twenty-one (60%) of 35 patients were infected with more than two strains of different cagA, iceA1, babA, and vacA genotypes. None of cagA, iceA1, babA, and vacA s1/m1 were associated with peptic ulcer. In conclusion, most H. pylori isolates in Korea carry cagA, iceA1, and vacA s1c/m1 genes, and reside with multiple strains. These genes do not correlate with the peptic ulcer in the Korean patients.
Adult ; Aged ; Bacterial Proteins/*genetics ; Female ; Genotype ; Helicobacter pylori/*classification/genetics/pathogenicity ; Human ; Male ; Middle Age ; Peptic Ulcer/*etiology/microbiology

Pustular psoriasis refers to a group of disorder characterized by recalcitrant, sterile pustular eruption. It classified into four clinical patterns: Zumbusch, annular, exanthematous, and localized. Annular pustular psoriasis consists of gyrate, annular lesions with an erythematous, scaly, pustular margin. In contrast to the Zumbusch variety, the annular type is benign and less severe. We herein report a case of annular pustular psoriasis of a 9-year-old girl with review of the literature.
Child ; Female ; Humans ; Psoriasis*