Sequences from the clones of full-length enriched cDNA libraries serve as valuable resources for functional genomics related studies, genome annotation and SNP discovery. We analyzed 7,392 high-quality chromatograms (Phred value >30) obtained from sequencing the 5' ends of clones derived from full-length enriched cDNA libraries of Korean native pigs including brainstem, liver, cerebellum, neocortex and spleen libraries. In addition, 50,000 EST sequence trace files obtained from GenBank were combined with our sequences to identify cSNPs in silico. The process generated 11,324 contigs, of which 2,895 contigs contained at least one SNP and among them 610 contigs had a minimum of one sequence from Korean native pigs. Of 610 contigs, we randomly selected 262 contigs and performed in silico analysis for the identification of cSNPs. From the results, we identified 1,531 putative coding single nucleotide polymorphisms (cSNPs) and the SNP detection frequency was one SNP per 465 bp. A large-scale sequencing result of clones from full-length enriched cDNA libraries and identified cSNPs will serve as a useful resource to functional genomics related projects such as a pig HapMap project in the near future
Brain Stem ; Cerebellum ; Clinical Coding ; Clone Cells ; Computer Simulation ; Databases, Nucleic Acid ; DNA, Complementary ; Gene Library ; Genome ; Genomics ; HapMap Project ; Liver ; Neocortex ; Polymorphism, Single Nucleotide ; Spleen ; Swine

Drug-induced hypersensitivity pneumonitis results from interactions between pharmacologic agents and the human immune system. We describe a 54-year-old man with hypersensitivity pneumonitis caused by cephalosporins with identical R1 side chains. The patient, who complained of cough with sputum, was prescribed ceftriaxone and clarithromycin at a local clinic. The following day, he complained of dyspnea, and chest X-ray revealed worsening of inflammation. Upon admission to our hospital, antibiotics were changed to cefepime with levofloxacin, but his pneumonia appeared to progress. Changing antibiotics to meropenem with ciprofloxacin improved his symptoms and radiologic findings. Antibiotics were de-escalated to ceftazidime with levofloxacin, and his condition improved. During later treatment, he was mistakenly prescribed cefotaxime, which led to nausea, vomiting, dyspnea and fever, and indications of pneumonitis on chest X-ray. We performed bronchoalveolar lavage, and the findings included lymphocytosis (23%), eosinophilia (17%), and a low cluster of differentiation (CD) 4 to CD8 ratio (0.1), informing a diagnosis of drug-induced pneumonitis. After a medication change, his symptoms improved and he was discharged. One year later, he was hospitalized for acute respiratory distress syndrome following treatment with ceftriaxone and aminoglycosides for an upper respiratory tract infection. After steroid therapy, he recovered completely. In this patient, hypersensitivity reaction in the lungs was caused by ceftriaxone, cefotaxime, and cefepime, but not by ceftazidime, indicating that the patient's hypersensitivity pneumonitis was to the common R1 side chain of the cephalosporins.
Alveolitis, Extrinsic Allergic* ; Aminoglycosides ; Anti-Bacterial Agents ; Bronchoalveolar Lavage ; Cefotaxime ; Ceftazidime ; Ceftriaxone ; Cephalosporins* ; Ciprofloxacin ; Clarithromycin ; Cough ; Diagnosis ; Drug-Related Side Effects and Adverse Reactions ; Dyspnea ; Eosinophilia ; Fever ; Humans ; Hypersensitivity ; Immune System ; Inflammation ; Levofloxacin ; Lung ; Lymphocytosis ; Middle Aged ; Nausea ; Pneumonia ; Respiratory Distress Syndrome, Adult ; Respiratory Tract Infections ; Sputum ; Thorax ; Vomiting

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BACKGROUND: Chronic obstructive pulmonary disease (COPD) is one of the leading causes of disability and mortality worldwide. The aim of this study was to evaluate the risk factors associated with recurrent hospital admissions for exacerbation of COPD in Korea. METHODS: A retrospective study of 77 consecutive patients hospitalized for exacerbation of COPD at Pusan National University Hospital during the time period January 2005 to May 2008 was performed. The information was collected from the hospitalization period: clinical information, spirometric measures, and laboratory variables. In addition, socioeconomic characteristics, co-morbidity, anxiety, and depression were reviewed. Frequent readmission was defined as 2 or more hospitalizations in the year following discharge. RESULTS: During the 1-year period after discharge, 42 patients (54.6%) reported one hospital admission and 35 patients (45.4%) reported 2 or more hospital readmissions. Among the 35 frequent readmission patients, 4 had more than 10 readmissions. Univariate analysis showed that a body mass index (BMI) <18.5 kg/m2, duration >36 months, forced expiratory volume in 1 second (FEV1) <50% predicted, arterial CO2 partial pressure (PaCO2) >40 mm Hg, and arterial oxygen saturation (SaO2) <95% at discharge were associated significantly with frequent readmissions. The multivariate analysis revealed that BMI <18.5 kg/m2, PaCO2 >40 mm Hg at discharge were independently associated with frequent readmissions for exacerbation of COPD. CONCLUSION: Frequent readmissions for exacerbation of COPD were associated with low BMI and hypercapnia at discharge.
Anxiety ; Body Mass Index ; Cinnarizine ; Depression ; Forced Expiratory Volume ; Hospitalization ; Humans ; Hypercapnia ; Multivariate Analysis ; Oxygen ; Partial Pressure ; Patient Readmission ; Pulmonary Disease, Chronic Obstructive ; Retrospective Studies ; Risk Factors

BACKGROUND: We evaluated the clinical outcomes and prognostic factors of patients requiring prolonged mechanical ventilation (PMV), defined as ventilator care for > or =21 days, who were admitted to the medical intensive care unit (ICU) of a university hospital in Korea. METHODS: During the study period, a total of 2,644 patients were admitted to the medical ICU, and 136 patients (5.1%) were enrolled between 2005 and 2010. RESULTS: The mean age of the patients was 61.3+/-14.5 years, and 94 (69.1%) were male. The ICU and six-month cumulative mortality rates were 45.6 and 58.8%, respectively. There were 96 patients with tracheostomy placement after admission and their mean period from admission to the day of tracheostomy was 21.3+/-8.4 days. Sixty-three patients (46.3%) were successfully weaned from ventilator care. Of the ICU survivors (n=74), 34 patients (45.9%) were transferred to other hospitals (not university hospitals). Two variables (thrombocytopenia [hazard ratio (HR), 1.964; 95% confidence interval (CI), 1.225~3.148; p=0.005] and the requirement for vasopressors [HR, 1.822; 95% CI, 1.111~2.986; p=0.017] on day 21) were found to be independent factors of survival on based on the Cox proportional hazard model. CONCLUSION: We found that patients requiring PMV had high six-month cumulative mortality rates, and that two clinical variables (measured on day 21), thrombocytopenia and requirement for vasopressors, may be associated with prognostic indicators.
Humans ; Critical Care ; Intensive Care Units ; Korea ; Male ; Respiration, Artificial ; Survivors ; Thrombocytopenia ; Tracheostomy ; Ventilators, Mechanical

PURPOSE: Evidence regarding the usefulness of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in predicting the prognosis of non-small cell lung cancer is increasing. However, data on small cell lung cancer (SCLC) are scarce. The aim of this study was to evaluate the prognostic value of metabolic parameters measured using 18F-FDG PET/CT in patients with SCLC. MATERIALS AND METHODS: We conducted a retrospective review of 114 patients with pathologically proven SCLC (26 cases of limited disease and 88 cases of extensive disease) who underwent pretreatment 18F-FDG PET/CT. The maximal SUV (SUVmax) was used quantitatively for determination of FDG PET activity. The SUVmax of the primary tumor (primary SUVmax), the sum of SUVmax values of malignant lesions (SUVsum), and the mean SUVmax of malignant lesions were calculated. RESULTS: The patient population was subdivided using a median SUVsum value of 24.6. High SUVsum showed a significant association with known factors for poor prognosis, including higher neuron-specific enolase (p=0.010), CYFRA 21-1 (p=0.014), and extensive disease status (p=0.007). Patients with high SUVsum had significantly shorter median overall survival (6.6 months vs. 13.0 months, p<0.001) and progression-free survival (5.2 months vs. 8.0 months, p<0.001) than patients with low SUVsum. Results of multivariate analysis showed that SUVsum, chemotherapy cycles, and the response to first-line treatment were significant prognostic factors of survival. In contrast, mean SUVmax and primary SUVmax were not significant predictors of survival. CONCLUSION: In this study, metabolic burden represented by SUVsum from pretreatment 18F-FDG PET/CT was an independent prognostic factor in patients with SCLC.
Carcinoma, Non-Small-Cell Lung ; Disease-Free Survival ; Drug Therapy ; Electrons* ; Fluorodeoxyglucose F18 ; Humans ; Multivariate Analysis ; Phosphopyruvate Hydratase ; Positron-Emission Tomography and Computed Tomography ; Prognosis ; Retrospective Studies ; Small Cell Lung Carcinoma* ; Tumor Burden

Churg-Strauss syndrome is a rare form of systemic necrotizing vasculitis that occurs exclusively in patients with asthma, and is associated with blood and tissue eosinophilia. The classic pathology findings in the lung include a combination of eosinophilic pneumonia, granulomatous inflammation and necrotizing vasculitis. However, there are few reports of tracheobronchial mucosal lesions in Churg-Strauss syndrome. We report a case of Churg-Strauss syndrome with multiple tracheobronchial mucosal lesions in a 33-year-old man with a history of bronchial asthma and allergic rhinitis. He had been diagnosed with community acquired pneumonia at another hospital and was treated with antibiotics. However, the chest radiographic findings were aggravated and showed multifocal consolidations in the whole lung fields. He was transferred to the Asan Medical Center. Fiberoptic bronchoscopy revealed multiple nodular mucosal lesions of the trachea and bronchi. The histopathology of the mucosal lesions revealed necrotizing bronchial inflammation with eosinophilic infiltration. Video Assisted Thoracic Surgery was performed. The wedge resected lung tissue revealed chronic eosinophilic pneumonia that was consistent with Churg-Strauss syndrome. Methylprednisolone (1 mg/kg q 8 hr) was prescribed and his symptoms resolved gradually. The chest radiographic findings improved significantly, and a follow-up fiberoptic bronchoscopy performed eight days later showed that the tracheobronchial mucosal lesions had resolved. The patient was prescribed oral prednisolone for 20 months after discharge. Currently, the patient is not taking steroids and is being followed up.
Adult ; Anti-Bacterial Agents ; Asthma ; Bronchi ; Bronchoscopy ; Churg-Strauss Syndrome ; Eosinophilia ; Eosinophils ; Follow-Up Studies ; Humans ; Inflammation ; Lung ; Methylprednisolone ; Pneumonia ; Prednisolone ; Pulmonary Eosinophilia ; Rhinitis ; Rhinitis, Allergic, Perennial ; Steroids ; Thoracic Surgery, Video-Assisted ; Thorax ; Trachea ; Vasculitis

PURPOSE: High mobility group box 1 (HMGB1) plays a central role in the pathogenesis of sepsis and multiple organ dysfunction syndromes. We investigated the associations of a single nucleotide polymorphism (SNP; rs1045411) in HMGB1 with various clinical parameters, severity, and prognosis in patients with sepsis, severe sepsis, or septic shock. MATERIALS AND METHODS: We enrolled 212 adult patients followed for 28 days. All patients were genotyped for rs1045411, and the serum levels of HMGB1 and several cytokines were measured. RESULTS: The proportions of patients according to genotype were GG (71.2%), GA (26.4%), and AA (2.4%). Among patients with chronic lung disease comorbidity, patients with a variant A allele had higher positive blood culture rates and higher levels of various cytokines [interleukin (IL)-1beta, IL-6, IL-10, IL-17, and tumor necrosis factor-alpha] than those with the GG genotype. In the analysis of those with diabetes as a comorbidity, patients with a variant A allele had higher blood culture and Gram-negative culture rates than those with GG genotypes; these patients also had a higher levels of IL-17. In the analysis of those with sepsis caused by a respiratory tract infection, patients with a variant A allele had higher levels of IL-10 and IL-17 (all p<0.05). This polymorphism had no significant impact on patient survival. CONCLUSION: The variant A allele of rs1045411 appears to be associated with a more severe inflammatory response than the GG genotype under specific conditions.
Adult ; Aged ; Alleles ; Asian Continental Ancestry Group/genetics ; China/epidemiology ; Cytokines/*blood/*genetics ; Female ; Genotype ; HMGB1 Protein/blood/*genetics ; Humans ; Interleukin-10/genetics ; Interleukin-17/genetics ; Interleukin-6/blood ; Male ; Middle Aged ; Polymorphism, Genetic/*genetics ; Polymorphism, Single Nucleotide/*genetics ; Prognosis ; Republic of Korea ; Sepsis/immunology/*metabolism/mortality ; Shock, Septic/immunology/*metabolism/mortality ; Survival ; Tumor Necrosis Factor-alpha/genetics

We report on a rare case of sarcoidosis that developed after chemotherapy for ovarian cancer, and mimicked a cancer metastasis. A 52-year-old female diagnosed with stage III ovarian cancer underwent curative surgery and postoperative chemotherapy. Four months later, her whole-body positron emission tomography and computed tomography (CT) scan showed high uptake in the mediastinal lymph nodes, and ovarian cancer recurrence was suspected. Biopsy of the mediastinal lymph nodes and subcutaneous nodules revealed noncaseating granulomas. These lesions resolved spontaneously without treatment; however, newly developed perilymphatic and centrilobular nodules were observed on follow-up chest CT. Surgical biopsy of these lesions also showed noncaseating granulomas. She was finally diagnosed with sarcoidosis.
Biopsy ; Drug Therapy* ; Female ; Follow-Up Studies ; Granuloma ; Humans ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis* ; Ovarian Neoplasms* ; Positron-Emission Tomography and Computed Tomography ; Recurrence ; Sarcoidosis* ; Tomography, X-Ray Computed

Pulmonary paragonimiasis is a relatively rare cause of lung disease revealing a wide variety of radiologic findings, such as air-space consolidation, nodules, and cysts. We describe here a case of pulmonary paragonimiasis in a 27-year-old woman who presented with a 2-month history of cough and sputum. Based on chest computed tomography (CT) scans and fluorodeoxyglucose positron emission tomography (FDG-PET) findings, the patient was suspected to have a metastatic lung tumor. However, she was diagnosed as having Paragonimus westermani infection by an immunoserological examination using ELISA. Follow-up chest X-ray and CT scans after chemotherapy with praziquantel showed an obvious improvement. There have been several reported cases of pulmonary paragonimiasis mimicking lung tumors on FDG-PET. However, all of them were suspected as primary lung tumors. To our knowledge, this patient represents the first case of paragonimiasis mimicking metastatic lung disease on FDG-PET CT imaging.
Adult ; Animals ; Diagnostic Errors ; Female ; Humans ; Lung Diseases, Parasitic/*diagnosis/*parasitology/radiography/radionuclide imaging ; Lung Neoplasms/*diagnosis ; Paragonimiasis/*diagnosis/*parasitology/radiography/radionuclide imaging ; Paragonimus westermani/isolation & purification ; Positron-Emission Tomography ; Tomography, X-Ray Computed