The type-specific PCR and the sequence analysis of 56 kDa gene of Orientia tsutsugamushi infected in field rodents specimens have shown intratypic genetic heterogeneity in genotype Karp. In sequence comparison, this genetic heterogeneity was mainly due to insertion or deletion of a repeated unit in variable domain I (VDI) region. These results suggested that genetic duplication or deletion of the specific sequence rnight be involved in intratypic genetic heterogeneity of Orientia tsutsugamushi.
Genetic Heterogeneity* ; Genotype* ; Orientia tsutsugamushi* ; Polymerase Chain Reaction ; Rodentia ; Sequence Analysis

No Abstract Available.
Arthroplasty* ; Knee*

No abstract available.
Leiomyoma* ; Vagina*

PURPOSE: We evaluated the MR and CT findings of the masticator space lesions in order to identify the differences among the malignant and benign tumors and infectious conditions. MATERIALS AND METHODS: MR and CT findings in 46 cases with proven masticator space lesions were reviewed retrospectively. We analysed the involvement of masticator muscles, adjacent spaces, orbit and intracrahium, homogeneity, necrosis, cystic changes, growth patterns, calcifications, enhancement patterns, MR signal intensity, and CT attenuation. RESULTS: Among the 29 cases of malignant tumors, seven cases were mandibular tumors including four chondrosarcomas, and 22 cases were extramandibular tumors. Malignant tumors of mandibular origin showed large masses with severe bone destruction and epicenter of mandible. Extramandiblular malignant tumors showed the epicenter out of the mandible and less severe bone destruction than mandibular tumors: Among the nine benign tumors, four cases were ameloblastomas which showed the well-defined masses and the expansion of the mandible, and four cases were extramandibular tumors which showed well-marginated extramandibular masses with no bone destruction. Among the eight infectious conditions, five cases were mandibular osteomyelitis with or without abscess formations, and the other three cases were infections from adjacent soft tissue or limited to the soft tissue. CONCLUSION: By careful observations of growth patterns, involvement of the masticator and adjacent spaces, bone changes, and epicenter of the lesions, one can discriminate a mandibular lesion from an extramandibular lesion. With this approach, it is thought to be easier to suggest a dignosis among a wide spectrum of masticator lesions.
Abscess ; Ameloblastoma ; Chondrosarcoma ; Magnetic Resonance Imaging* ; Mandible ; Muscles ; Necrosis ; Orbit ; Osteomyelitis ; Retrospective Studies

PURPOSE: To evaluate the diagnostic value of radiologic studies in the Cushing's disease MATERIALS AND METHODS: We analyzed retrospectively the CT(n=19, dynamic CT was not perfomed), MR (n=23, dynamic MR in 2 cases), and the results of inferior petrosal sinus sampling(IPSS)(n=13) in 25 patients(19 women, 6men, age range 16-58, mean 32.2) with pathologically-confirmed ACTH secreting pituitary adenoma. We analyzed the radiologic findings and determined how accurately each method could detect and lateralize the lesion within the pituitary gland. The results were compared with the surgical findings and with each other. RESULTS: Seven patients(28%) out of 25 had macroadenomas and the lesions were detected and correctly diagnosed by CT and MR in all. Eighteen patients(72%) had microadenoma. In patients with microadenoma the sensitivity was 38.5%(5/13) in CT, 64.7%(11/17) in MR, 90.9%(10/11) in IPSS. In two patients with dynamic MR, in whom the conventional Gd-enhanced MR showed false negative results, the lesions were detected as low signal intensity mass and correctly lateralized. Considering the results of both MR and IPSS, the sensitivity increased up to 94.1%(17/18). CONCLUSION: Considering the invasiveness of IPSS, Gd-enhanced MR, preferably dynamic, seems to be an imaging modality of choice in Cushing's disease. Combined use of IPSS in selected patients further increases the accuracy of diagnosis and lateralization.
ACTH-Secreting Pituitary Adenoma ; Diagnosis ; Female ; Humans ; Pituitary Gland ; Retrospective Studies

The 86 strains of field rodents captured in Chollanamdo were analyzed its infection rates of Orientia tsutsugamushi by nested PCR. The detection rate of O. tsutsugamushi was 14.3 % in A. agrarius whereas O. tsutsugamushi could not be detected in C. lasiura. In locality, the rodents captured in the mountainous area showed higher detection rate than suburban area. In the case of detection rate by organs, the spleen was most appropriate specimen, but in two cases, O. tsutsugamushi could be detected in only kidney specimens. The major serotype of detected O. tsutsugamushi was serotype Karp, but four cases were serotype Boryong. These serotypes were confirmed by nucleotide sequence determination of amplified PCR products. In conclusion, the serotype Karp was the major O. tsutsugamushi in Chollanamdo.
Base Sequence ; Chungcheongnam-do ; Jeollanam-do* ; Kidney ; Orientia tsutsugamushi* ; Polymerase Chain Reaction* ; Rodentia* ; Spleen

No abstract available.
Baculoviridae* ; Herpesvirus 1, Suid* ; Pseudorabies*

In situ follicular lymphoma is a newly defined entity among the lymphoid neoplasms and is defined as architecturally normal-appearing lymph nodes and other lymphoid tissues that have one or more follicles that demonstrate bcl-2 overexpressing centrocytes and centroblasts, with or without a monomorphic cytologic appearance suggestive of follicular lymphoma. Here we present a case of in situ follicular lymphoma diagnosed during the follow-up after a complete response to the treatment of lymphocyte-rich classical Hodgkin's lymphoma. In our case, because only a few germinal centers contained bcl-2 overexpressing cells, we missed the diagnosis of in situ follicular lymphoma in the initial histological examination. We could establish the diagnosis only after performing bcl-2 immunostaining in the sequential biopsy. Therefore, we recommend that careful histological examination along with bcl-2 immunostaining is needed in patients with suspicious clinical findings.
Biopsy ; Follow-Up Studies ; Germinal Center ; Hodgkin Disease ; Humans ; Lymph Nodes ; Lymphoid Tissue ; Lymphoma ; Lymphoma, Follicular ; Precancerous Conditions

BACKGROUND: The purpose of this study was to assess the clinical outcome and echocardiographic incidence of restenosis after successful percutaneous transmitral commissurotomy (PTMC) and to identify predictors of restenosis. METHODS: Between 1989 and 1992, Inoue PTM (n=73) and double balloon technique (n=85) were used in 158 consecutive patients (male 52, age; 41+/-11 year) with mitral stenosis. Clinical and echocardiographic examinations were performed annually in 137 patients who exhibited good initial result with PTMC (mitral valve area 1.5cm (2) and mitral regurgitation[MR] 2+). Restenosis was defined as a mitral valve area< (MVA) 1.5cm (2) or more than 50% loss of the initial gain in MVA. Commissural mitral regurgitation (CMR) was defined as MR originating from medical or lateral commissure on color flow imaging and regarded as an index of complete commissural splitting. RESULTS: Immediately after PTMC, MVA increased from 0.9+/-0.2cm (2) to 1.8+/-0.3cm (2) and functional class improved up to NYHA class 1 or 2 in all patients. Annual echocardiographic follow-ups were completed in 129 (94%) patients and mean follow-up duration was 54+/-21 months. Adverse events occurred in 16 (13%) patients (1 death, 3 mitral valve replacement, 3 re-PTMCs, 9 deterioration of the NYHA class), and restenosis occurred in 41 (32%) patients. Event-free and restenosis-free survival rates at 7 years were 776 % and 586 %, respectively. According to multivariate Cox analysis, restenosis (p=0.0017, relative risk[r.r]=2.82) was the only predictor of adverse events ; smaller increase ( 1.0cm (2)) of MVA (p=0.0001, r.r=4.8) and the absence of CMR (p=0.0000, r.r=4.8) were independent predictors of restenosis. CONCLUSION: Long-term clinical outcomes and restenosis rates after PTMC are favorable and immediate results after PTMC can predict late restenosis better than baseline clinical and echocardiographic characteristics.
Echocardiography* ; Follow-Up Studies ; Humans ; Incidence ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Survival Rate

A 70-year-old woman developed sick sinus syndrome associated with thyrotoxicosis. Initial T3 was above 800ng/dl and TSH was below 0.05IU/ml. But sinus node dysfunction was resolved upon achieving a euthyroid state. This clinical course suggest that transient reversible sinus node dysfunction could be developed due to thyrotoxicosis.
Aged ; Female ; Humans ; Sick Sinus Syndrome* ; Thyrotoxicosis*