The effect of a secretory proteinase from the pathogenic amoebae Acanthamoeba castellanii on hosts defense-oriented or regulatory proteins such as immunoglobulins, interleukin-1, and protease inhibitors was investigated. The enzyme was found to degrade secretory immunoglobulin A (sIgA), IgG, and IgM. It also degraded interleukin-1alpha (IL-1alpha) and IL-1beta. Its activity was not inhibited by endogenous protease inhibitors, such as alpha2-macroglobulin, alpha1-trypsin inhibitor, and alpha2-antiplasmin. Furthermore, the enzyme rapidly degraded those endogenous protease inhibitors as well. The degradation of hosts defense-oriented or regulatory proteins by the Acanthamoeba proteinase suggested that the enzyme might be an important virulence factor in the pathogenesis of Acanthamoeba infection.
Acanthamoeba/*enzymology/pathogenicity ; Animals ; Endopeptidases/*physiology ; Immunoglobulins/*metabolism ; Interleukin-1/*metabolism ; Protease Inhibitors/*metabolism ; Support, Non-U.S. Gov't ; Virulence

PURPOSE: The purpose of this study is to investigate clinical features and causative organisms in febrile infants younger than three months, to help identification of high risk patients for serious bacterial infection (SBI). METHODS: A total of 313 febrile infants younger than three months, who had visited Seoul National University Children's Hospital from January 2008 to December 2010 were included. Clinical features, laboratory findings, causative organisms, and risk factors of SBI were analyzed by retrospective chart review. Causative bacterial or viral pathogens were identified by gram stain and cultures, rapid antigen tests, or the polymerase chain reaction from clinically reliable sources. RESULTS: Among 313 infants, etiologic organisms were identified in 127 cases (40.6%). Among 39 cases of bacterial infections, Escherichia coli (66.7%) and Streptococcus agalactiae (12.8%) were common. Enterovirus (33.7%), respiratory syncytial virus (19.8%), and rhinovirus (18.8%) were frequently detected in 88 cases of viral infection. Patients with SBI (39 cases) showed significantly higher values of the white blood cell count (14,473+/-6,824/mm3 vs. 11,254+/-5,775/mm3, P=0.002) and the C-reactive protein (6.32+/-8.51 mg/L vs. 1.28+/-2.35 mg/L, P<0.001) than those without SBI (274 cases). The clinical risk factors for SBI were the male (OR 3.7, 95% CI 1.5-8.9), the presence of neurologic symptoms (OR 4.8, 95% CI 1.4-16.8), and the absence of family members with respiratory symptoms (OR 3.6, 95% CI 1.2-11.3). CONCLUSION: This study identified common pathogens and risk factors for SBI in febrile infants younger than three months. These findings may be useful to guide management of febrile young infants.
Bacterial Infections ; C-Reactive Protein ; Enterovirus ; Escherichia coli ; Fever ; Humans ; Infant ; Infant, Newborn ; Leukocyte Count ; Male ; Neurologic Manifestations ; Polymerase Chain Reaction ; Respiratory Syncytial Viruses ; Retrospective Studies ; Rhinovirus ; Risk Factors ; Sepsis ; Streptococcus agalactiae

No abstract available.
Female ; Ovary* ; Teratoma*

No abstract available.
Humans ; Peptic Ulcer*

No abstract available.
Administration, Oral* ; Animals ; Carbon Disulfide* ; Carbon* ; Rats*

Individuals with Asia type DEL blood group, the RhD-variant that classified as serologically RhD-negative, do not produce anti-D even when exposed to the D-antigen. Therefore, it is considered safe to transfuse RhD-positive blood products to them. However, such transfusions are still rare in medical institutions, with only two cases reported in Korea. Here, we present cases of two additional patients based on our experience. A 60-year-old female patient undergoing extra corporeal membrane oxygenation (ECMO) for myocarditis presented with severe anemia.The patient was serologic RhD-negative. Due to the lack of RhD-negative RBC inventory for emergency transfusion, RhD-positive blood was transfused. After confirming the patient’s RHD genotype as Asia type DEL, the planned RhD-positive blood transfusion was continued. A total of 13 units of RhD-positive RBCs and 26 units of single donor platelets (SDPs) were transfused over 25 days. Throughout this period, all unexpected antibody tests were negative. The second patient, a 50-year-old male diagnosed with myelodysplastic syndrome (MDS), was serologic RhD-negative, and the RHD genotyping confirmed Asia type DEL. During the hospitalization period, a total of 113 units of RhD-positive SDPs and 10 units of fresh frozen plasma (FFP) were transfused over 64 days, and all unexpected antibody tests were negative. These two cases suggest the transfusion of RhD-positive blood products to patients with Asia type DEL is safe.

PURPOSE: This study aimed to investigate the association between respiratory virus infection and pneumococcal colonization in children. METHODS: From May 2009 to June 2010, nasopharyngeal (NP) aspirates were obtained from patients under 18 years old who visited Seoul National University Children's Hospital for respiratory symptoms. NP samples were used to detect respiratory viruses (influenza virus A and B, parainfluenza virus 1, 2 and 3, respiratory syncytial virus A and B, adenovirus, rhinovirus A/B, human metapneumovirus, human coronavirus 229E/NL63 and OC43/HKU1) by RT-PCR and pneumococcus by culture. RESULTS: Median age of the patients was 27 months old. A total of 1,367 NP aspirates were tested for respiratory viruses and pneumococcus. Pneumococcus was isolated from 228 (16.7%) of samples and respiratory viruses were detected from 731 (53.5%). Common viruses were rhinovirus (18.4%), respiratory syncytial virus (RSV) A (10.6%), adenovirus (6.9%), influenza virus A (6.8%). Pneumococcal isolation rate was significantly higher in the cases of positive virus detection than negative detection [21.3% (156/731) vs. 11.3% (72/636), P<0.001]. For individual viruses, pneumococcal isolation rate was positively associated with detection of influenza virus A [24.7% (23/93) vs 16.1% (205/1274), P=0.001], RSV A [28.3% (41/145) vs 15.3% (187/1222), P=0.001], RSV B [31.3% (10/32) vs 16.3% (218/1335), P=0.042], rhinovirus A/B [22.6% (57/252) vs 15.3% (171/1115), P=0.010]. CONCLUSION: The study revealed that pneumococcal isolation from NP aspirates is related with respiratory virus detection. The result of this study could be used to investigate how respiratory viruses and pneumococcus cause clinical diseases.
Adenoviridae ; Child* ; Colon* ; Coronavirus ; Humans ; Metapneumovirus ; Orthomyxoviridae ; Paramyxoviridae Infections ; Respiratory Syncytial Viruses ; Rhinovirus ; Seoul ; Streptococcus pneumoniae

PURPOSE: To compare the surgical results according to the IOL implantation time in patients who were performed simultaneous lens extraction, vitrectomy and silicone oil endotamponade. METHODS: We reviewed the medical records of 60 eyes in 57 patients with vitreoretinal diseseases. The group I included 32 eyes those were performed simultaneous lens extraction, vitrectomy and silicone oil endotamponade as the first surgery, and sequential IOL implantation at the time of silicone oil removal as the second surgery. The group II included 28 eyes those were performed simultaneous lens extraction, vitrectomy, silicone oil endotamponade and IOL implantation as the first surgery, and sequential oil removal as the second surgery. The cases were evaluated 6 months after silicone oil removal. Anatomical and functional success rate, difference of postoperative predictive refraction, postoperative complication occurrence rate were compared between two groups. RESULTS: The anatomical successes were achieved in 93.8% (30/32 eyes) and 92.9% (26/28 eyes) in the group I and II respectively. The functional successes were achieved in 71.9% (23/32 eyes) and 78.6% (22/28 eyes) in the group I and II respectively. The differences between preoperative predicted target refraction and postoperative final refraction were 0.68D and 0.92D in the group I and II respectively. The incidence of postoperative anterior chamber reaction and secondary glaucoma were significantly high after second surgery in the group I. CONCLUSIONS: We recommend a simultaneous implantation of IOL at the combined surgery of lens extraction and vitrectomy with silicone oil endotamponade to reduce postoperative complications.
Anterior Chamber ; Endotamponade ; Glaucoma ; Humans ; Incidence ; Lenses, Intraocular ; Medical Records ; Postoperative Complications ; Silicone Oils ; Vitrectomy*

PURPOSE: To determine whether C-reactive protein (CRP) can be used as a parameter to assess the safety of discontinuing antibiotic therapy and allows a shorter course of therapy in neonates treated for suspected bacterial infection. METHODS: We have experienced 193 cases of suspected neonatal bacterial infection at Pusan Maryknoll Hospital. CRP levels were measured daily by immunonephelometry. Infants with initial CRP levels less than 0.8mg/dL were considered unlikely to be infected, and antibiotic therapy was stopped (group A; n=82). If three daily serial CRP levels were less than 0.8mg/dL, antibiotics were discontinued (group B; n=51). Sixty cases were treated for at least 7 days irrespective of CRP results (group C; n=60), and relapse rates of bacterial infection were compared between the three groups within one month after discharge. RESULTS: Within the one month follow-up period, two infants (2.4%) in group A, one infant (1.3%) in group B, two infants (3.3%) in group C received antibiotics for possible relapse of bacterial infection. The relapse rate in these groups was very low and frequency of a second course of antibiotic therapy between these groups was not different. CONCLUSION: These data allow considerably shorter courses of antibiotic therapy, safe discontinuation by three serial CRP measurement and show that CRP can be a key parameter for guiding the duration of antibiotic treatment. In addition, it would cut the length and cost of hospital stays and diminish the side effects of parenteral antibiotics.
Anti-Bacterial Agents ; Bacterial Infections* ; Busan ; C-Reactive Protein* ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Length of Stay ; Recurrence

PURPOSE: To determine whether C-reactive protein (CRP) can be used as a parameter to assess the safety of discontinuing antibiotic therapy and allows a shorter course of therapy in neonates treated for suspected bacterial infection. METHODS: We have experienced 193 cases of suspected neonatal bacterial infection at Pusan Maryknoll Hospital. CRP levels were measured daily by immunonephelometry. Infants with initial CRP levels less than 0.8mg/dL were considered unlikely to be infected, and antibiotic therapy was stopped (group A; n=82). If three daily serial CRP levels were less than 0.8mg/dL, antibiotics were discontinued (group B; n=51). Sixty cases were treated for at least 7 days irrespective of CRP results (group C; n=60), and relapse rates of bacterial infection were compared between the three groups within one month after discharge. RESULTS: Within the one month follow-up period, two infants (2.4%) in group A, one infant (1.3%) in group B, two infants (3.3%) in group C received antibiotics for possible relapse of bacterial infection. The relapse rate in these groups was very low and frequency of a second course of antibiotic therapy between these groups was not different. CONCLUSION: These data allow considerably shorter courses of antibiotic therapy, safe discontinuation by three serial CRP measurement and show that CRP can be a key parameter for guiding the duration of antibiotic treatment. In addition, it would cut the length and cost of hospital stays and diminish the side effects of parenteral antibiotics.
Anti-Bacterial Agents ; Bacterial Infections* ; Busan ; C-Reactive Protein* ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Length of Stay ; Recurrence