BACKGROUND: A Pyrosequencing assay has been used in identification of fungal species such as Candida or Aspergillus and diagnosis of pathogenic bacteria such as Helicobacter pylori but there has been no report on successful isolation and identification of Malassezia yeasts using the pyrosequencing method. OBJECTIVE: Examine the applicability and plausibility of the pyrosequencing method in identification of the Malassezia species. METHODS: At internal transcribed spacer (ITS) sites 1 and 2, three primers were developed using Pyrosequencing Assay Design Software (Biotage AB). Pyrosequencing was performed on 11 standard strains and 83 genomic DNA samples obtained from 66 healthy controls aged from 1 to 80. RESULTS: The eleven Malassezia standard species and 83 genomic DNA samples were successfully identified using the pyrosequencing assay. CONCLUSION: The pyrosequencing method is a new tool for analysis of Malassezia yeasts, and its precision and rapidity suggests its clinical applicability.
Aged ; Aspergillus ; Bacteria ; Candida ; DNA ; Helicobacter pylori ; Humans ; Malassezia ; Yeasts

BACKGROUND: A Pyrosequencing assay has been used in identification of fungal species such as Candida or Aspergillus and diagnosis of pathogenic bacteria such as Helicobacter pylori but there has been no report on successful isolation and identification of Malassezia yeasts using the pyrosequencing method. OBJECTIVE: Examine the applicability and plausibility of the pyrosequencing method in identification of the Malassezia species. METHODS: At internal transcribed spacer (ITS) sites 1 and 2, three primers were developed using Pyrosequencing Assay Design Software (Biotage AB). Pyrosequencing was performed on 11 standard strains and 83 genomic DNA samples obtained from 66 healthy controls aged from 1 to 80. RESULTS: The eleven Malassezia standard species and 83 genomic DNA samples were successfully identified using the pyrosequencing assay. CONCLUSION: The pyrosequencing method is a new tool for analysis of Malassezia yeasts, and its precision and rapidity suggests its clinical applicability.
Aged ; Aspergillus ; Bacteria ; Candida ; DNA ; Helicobacter pylori ; Humans ; Malassezia ; Yeasts

PURPOSES: Rotaviruses are the main cause of infantile diarrheal diseases worldwide. The purpose of this study is to obtain epidemiologic data of rotavirus infections in Korea. METHODS: Stool specimens were collected from 150 patients with acute diarrheal symptoms, who were admitted to Yonsei Medical Center and Chungbuk National University Hospital. After isolating the virus from the specimens, the viruses were identified as rotaviruses by electron microscope and fluorescent microscope after staining with rotavirus VP6-specific monoclonal antibody. RNA was extracted from the specimens by modified phenol/chloroform method. Electropherotying was done with extracted RNA samples after silver staining of the gels. Rotavirus serotyping was done using commercial serotyping ELISA kit. RESULTS: Rate of infection from rotavirus stool samples was 60%. Isolated rotaviruses were all serogroup A and a majority(46.0%) of these viruses were long type. Serotypes 1 and 2 were identified with serotype 1 being the majority(52.2%). There were no differences in these types between 1991 and 1992, and also between Seoul and Cheongju area. CONCLUSION: Electropherotype of rotavirus epidemic in Korea was serogroup A, and long type in the majority. Serotypes of rotavirus epidemic in Korea were type 1 and type 2. These results show that the rotavirus reassortant vaccine developed in America could also handle the rotaviral disease in Korea.
Americas ; Chungcheongbuk-do ; Diarrhea* ; Enzyme-Linked Immunosorbent Assay ; Gels ; Humans ; Korea* ; Prevalence* ; RNA ; Rotavirus Infections ; Rotavirus* ; Seoul ; Serotyping ; Silver Staining

Percutaneous needle aspiration biopsy is a relatively simple and safe procedure for the diagnosis of lung and mediastinal lesions. Systemic air embolism during and after percutaneous needle aspiration biopsy of the lung is very rare; however, it is still a complication that can cause fatal outcomes, such as cerebral infarction and myocardial infarction. Here, we report a 72-year-old woman who suffered a change in consciousness immediately after receiving a percutaneous needle aspiration biopsy for the pathologic examination of pulmonary nodules found during a routine health medical examination. She had left side weakness and ST segment elevation on an electrocardiogram. After a high concentration of oxygen, she recovered from neurological symptoms and electrocardiographic abnormalities. The authors report a case of air embolism occurring simultaneously in the brain and coronary arteries after percutaneous needle aspiration biopsy.
Aged ; Biopsy ; Biopsy, Needle* ; Brain ; Cerebral Infarction ; Consciousness ; Coronary Vessels ; Diagnosis ; Electrocardiography ; Embolism ; Embolism, Air* ; Fatal Outcome ; Female ; Humans ; Intracranial Embolism ; Lung* ; Myocardial Infarction ; Needles* ; Oxygen

An aortoesophageal fistula is one of the very few causes of upper gastrointestinal bleeding but can be fatal if the diagnosis is delayed. This usually occurs secondary to esophageal or aortic surgery. A primary aortoesophageal fistula is rare and less likely to be suspected. Here, we present a case of a primary aortoesophageal fistula that presented as massive upper gastrointestinal bleeding. An 81-year-old man with a history of aortic aneurysm had syncope and bright color hematemesis. The aortoesophageal fistula was not diagnosed early enough and the patient died. Therefore, emergency physicians should consider aortoesophageal fistula as a potential cause when encountering upper gastrointestinal bleeding.
Aged, 80 and over ; Aortic Aneurysm ; Diagnosis ; Emergencies ; Esophageal Fistula ; Fistula* ; Gastrointestinal Hemorrhage ; Hematemesis ; Hemorrhage* ; Humans ; Syncope

Background/Aims: As the global impact of the novel coronavirus disease 2019 (COVID-19) has been severe, many countries have intensified containment activities to eliminate virus transmission, through early detection and isolation strategies. To establish a proper quarantine strategy, it is essential to understand how easily the virus can spread in the communities. Methods: In this study, we collected detailed information on the circumstances in which human-to-human transmission occurred in the tertiary transmission cases of COVID-19 in the community. Results: On January 26, 2020, an imported case of COVID-19 was confirmed, and by February 10, 2020, one secondary transmission and three tertiary transmissions were identified. Secondary transmission occurred on the first day of illness of the infector, and his symptoms were suggestive of a common cold. The transmission occurred during a 90-minute long meal together in a restaurant. The people were sitting within one meter of each other, and had no direct contact. The tertiary transmission also occurred on the first-day illness of the other infector, and his only symptom was slight chills. The transmission occurred at a church during 2-hour-long worship, and two rows separated them. Conclusions Our findings suggest that mildly symptomatic patients with COVID-19 could transmit the virus from the first day of illness through daily activities in the community. Early detection and isolation of patients with COVID-19 may be challenging.

Background/Aims: As the coronavirus disease-2019 global pandemic progresses, screening of antiviral agents effective against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is urgently needed. In addition, considering the viral load kinetics of SARS-CoV-2, which peaks early in the illness, and the massive burden of the disease, which may increase in the near future, identifying well-tolerated oral antivirals becomes increasingly important. We examined the in vitro activity of lopinavir/ritonavir and hydroxychloroquine on SARS-CoV-2, at concentrations which can be used to treat coronavirus-19 patients with little concern of toxicity. Methods: Lopinavir/ritonavir (7/1.75 μg/mL), hydroxychloroquine base (1 or 2 μg/mL), or a combination thereof were administered 1 hour after the inoculation of SARS-CoV-2 to Vero cells at a multiplicity of infection of 0.05. We examined cytopathic effects of virus 48 hours after administration of the respective treatments and measured viral loads at three time points (0, 24, and 48 hours post-treatment) by quantitative real-time reverse-transcription polymerase chain reaction, and compared the results obtained from the different antiviral regimens tested. Results: The severity of cytopathic effects was lower in lopinavir/ritonavir-treated cells, and viral load was significantly reduced in this group compared with the control group (p < 0.001). However, hydroxychloroquine did not show significant inhibitory effects on anti-SARS-CoV-2-mediated cytotoxicity or on viral load at either concentration. Conclusions Lopinavir/ritonavir showed significant inhibitory effects on SARS-CoV-2 in vitro at its usual plasma concentration. However, the in vitro antiviral activity of hydroxychloroquine at concentrations commonly used in humans was minimal, whether used alone or in combination with lopinavir/ritonavir.

BACKGROUND/AIMS: Propofol is widely used for sedation during endoscopy. Because propofol may cause hepatic encephalopathy, hemodynamic compromise, and respiratory depression, cautious use is required in patients with liver cirrhosis. We evaluated the safety and efficacy of propofol in compensated cirrhosis during endoscopic examination. METHODS: Thirty-nine cirrhotic patients (19 and 20 cases of Child Pugh classes A and B, respectively) and 56 control subjects were included. The initial dose of propofol (40 mg) was increased by 20-mg increments until moderate sedation was achieved. The number connection test, flapping tremor test, blood pressure, heart rate, oxygen saturation, liver enzymes, and prothrombin time were evaluated before and after endoscopy. RESULTS: No significant change was observed in any parameter compared to baseline in either group. The mean dose of propofol was significantly lower in cirrhotic versus control subjects (49.7+/-15.8 versus 65.0+/-17.9 mg, respectively; p<0.001). Scores based on a visual analog scale evaluating patient satisfaction did not differ between groups (72+/-27 versus 64+/-26, respectively; p=0.196), nor did mean recovery time (16.4+/-9.8 versus 14.2+/-6.7 min, respectively; p=0.186). CONCLUSION: Propofol is safe and effective for moderate sedation in compensated liver cirrhosis.
Child ; Conscious Sedation ; Endoscopy ; Fibrosis ; Heart Rate ; Hematologic Tests ; Hemodynamics ; Hepatic Encephalopathy ; Humans ; Liver ; Liver Cirrhosis ; Oxygen ; Patient Satisfaction ; Propofol ; Prothrombin Time ; Respiratory Insufficiency ; Tremor

BACKGROUND/AIMS: Placement of stents in cases of inoperable malignant gastric outlet obstruction is difficult due to anatomical and technical problems. The aim of this study was to assess the feasibility, effectiveness, safety, and long-term outcome of a self-expandable metal stent (SEMS) as a means of providing palliative care for patients with an inoperable malignant gastric outlet obstruction, METHODS: Fifty-one consecutive patients (53 cases of stent insertion) with onoperable gastric outlet obstruction were treated palliatively with EsophaCoil, Choo's stent, or through-the-scope (TTS) stent. RESULTS: Technical Success was achieved in 46 cases (86.8%). Six cases of stent insertion failure were caused by acute angulation of the stenotic area and sereve distal luminal narrowing. The other failed case was due to the inappropriate location of the stent. In 41 cases, the patients (89.1%) could ingest soft or solid foods after successful insertion of the stents. All the remaining 16 cases of TTS SEMS had technical and clinical successes. During the follow-up (mean; 3.3+/-1.1 months, range; 1~11 months), there was 1case of aspiration pneumonia, 1 case of bowel perforation, 2 cases of stent migration, and 2 cases of stent occlusion by tumor ingrowth. CONCLUSIONS: Placement of a SEMS, especially TTS SEMS in patients with malignant gastric outlet obstruction is a feasible, effective, and safe palliative therapy.
Follow-Up Studies ; Gastric Outlet Obstruction* ; Humans ; Palliative Care ; Phenobarbital ; Pneumonia, Aspiration ; Stents*

No abstract available.
Pregnancy*