A total of 100 Vibrio spp. strains were examined for production of various extracellular enzyme and for plasmid content plasmid were subjected to digestion with restriction enzymes. Most of them produced extracellular enzyme more than one, especially V. parahaemolyticus and V. cholerae non-01 strains were showed production of various extracellular enzymes. About the 55% Vibrio spp. have the plasmid more than one, but a lot of Vibrio spp. (about 45%) did not possess any plasmid. Most of these plasmid various derivatives ranged from 2.4 kb-23 kb, especially two strains of V. mimicus and one strain of V. furnissii carried one high-molecular weight plasmid (molecular weight ranging between 70 kb-100 kb). Results of restriction analysis for plasmid of this three strains were by no means the rule. For detection of tdh and ctx gene, the virulence factor involved in the pathogenesis, we carried out the TDH, CT assay, PCR amplification, and hybridization. A total 11 strains were produced TDH, involved in 4 strains of V. parahaemolyticus and 1 strain of V. cholerae non-01 from clinical isolates and 6 strains of environmental isolates. Nine strains of 11 strains, involved in 4 strains of V. parahaemolyticus and 1 strain of V. cholerae non-01 from clinical isolates and 4 strains of V. parahaemolyticus from environmental isolates, could be successfully amplified in 400 bp by PCR, no amplification products were obtained from TDH-negative strains. The PCR results were consistent with DNA hybridization. In the experiments of ctx gene detection, in all, 3 strains of V. cholerae non-01 from clinical isolate and 1 strains of V. cholerae non-01 from environmental isolate were observed CT- positive. These CT-producing strains amplified in 302 bp by PCR for the detection of ctx gene. All CT-producing strains hybridized with digoxigenin-labeled DNA probe, while CT-negative strains did not hybridize. Also hybridization tests results for detection of ctx gene consistent with PCR.
Cholera ; Digestion ; DNA ; Plasmids ; Polymerase Chain Reaction ; Vibrio* ; Virulence Factors* ; Virulence*

Pulmonary metastasis occurs frequently in patients with gestational choriocarcinoma and most of these patients achieve remission with chemotherapy alone. Thus, the indications for surgical intervention are limited, but in appropriately selected patients, resection of a chemotherapy-resistant lung lesion can be curative. We have experienced that pulmonary metastatic choriocarcinoma in a drug-resistant patient was cured by pulmonary resection. So we report this case with a brief review of literatures.
Choriocarcinoma* ; Drug Therapy ; Female ; Humans ; Lung ; Neoplasm Metastasis ; Pregnancy

No abstract available.
Ultrasonography, Doppler, Color*

Spinal epidural emphysema is rare and has been described secondary to following medical intervention, such as lumbar puncture and epidural analgesia, pneumothorax or pneumomediastinum, degenerative disk disease, epidural abscess, and trauma. Rarely, it occurs after chest tube placement. We report a case of spinal epidural emphysema incidentally noted on HRCT after chest tube placement.
Analgesia, Epidural ; Chest Tubes ; Emphysema ; Epidural Abscess ; Epidural Space ; Mediastinal Emphysema ; Pneumothorax ; Spinal Puncture ; Subcutaneous Emphysema ; Thorax ; Tomography, X-Ray Computed

Precision medicine stands for 4Ps - precise, preventive, participatory, and personal; in which “precision” is important because the current modern medicine starts from “trial and error,” and “one does not fit all”. Current targeted therapies for cancer have changed treatment approaches and led the precision medicine; however, clinical use of liquid biopsy, using blood or other liquid specimens to characterize circulating tumor cells (CTC) or tumor genes instead of biopsies of tumor tissues, still awaits availability of more information regarding non-invasive cancer detection and characterization, prediction of treatment response, monitoring the disease course and relapse possibilities, identification of mechanisms of drug resistance, and newer pathogenesis. In this review, we will introduce the basic concept of CTC, circulating cell free DNA, and exosomes and their possible application for gastric cancer relevant with Helicobacter pylori infection.
Biopsy* ; DNA ; Drug Resistance ; Exosomes ; Helicobacter Infections* ; Helicobacter pylori ; Helicobacter* ; History, Modern 1601- ; Humans ; Neoplastic Cells, Circulating ; Precision Medicine ; Recurrence ; Stomach Neoplasms*

Background: Current research has not investigated the effect of thyroid-stimulating hormone suppression therapy with levothyroxine on the risk for developing subsequent primary cancers (SPCs). This study aimed to investigate the association between levothyroxine dosage and the risk for SPCs in thyroid cancer patients. Methods: We conducted a nationwide population-based retrospective cohort study form Korean National Health Insurance database. This cohort included 342,920 thyroid cancer patients between 2004 and 2018. Patients were divided into the non-levothyroxine and the levothyroxine groups, the latter consisting of four dosage subgroups according to quartiles. Cox proportional hazard models were performed to evaluate the risk for SPCs by adjusting for variables including cumulative doses of radioactive iodine (RAI) therapy. Results: A total of 17,410 SPC cases were observed over a median 7.3 years of follow-up. The high-dose levothyroxine subgroups (Q3 and Q4) had a higher risk for SPC (adjusted hazard ratio [HR], 1.14 and 1.27; 95% confidence interval [CI], 1.05–1.24 and 1.17– 1.37; respectively) compared to the non-levothyroxine group. In particular, the adjusted HR of stomach (1.31), colorectal (1.60), liver and biliary tract (1.95), and pancreatic (2.48) cancers were increased in the Q4 subgroup. We consistently observed a positive association between high levothyroxine dosage per body weight and risk of SPCs, even after adjusting for various confounding variables. Moreover, similar results were identified in the stratified analyses according to thyroidectomy type and RAI therapy, as well as in a subgroup analysis of patients with good adherence. Conclusion High-dose levothyroxine use was associated with increased risk of SPCs among thyroid cancer patients regardless of RAI therapy.

59 children seen from Jan. 1990 to Jun. 1994 with epilepsy were retrospectively reviewed to evaluate the tendency of recurrence and the risk factors after the antiepileptic drug discontinuation. The population consisted of 59 children who were seizure free for more than 2 years and followed up for more than 1 year after the discontinuation via department of pediatrics, Yonsei University, Wonju College of Medicine. We analyzed risk factors of recurrence(age of seizure onset, seizure frequency before treatment, interval from seizure onset to start of treatment, duration from neurologic disorders, and EEG done just before discontinuation) between non-recurrent group(43 patients) and recurrent group(16 patients). The results were as follows: 1) In 59 patients with epilepsy, 16(27.1%) patients showed recurrence after the discontinuation and 14(87.5%) patients of those were developed during taperring and within less than 1 year. The probability of recurrent seizure by Kaplan-Meier curve at 12 and 24 months after discontinuation are 23.7% and 33.6% respectively. 2) There were significant differences on seizure frequency before treatement, duration from start of treatment to control (9.5months vs 31.1months), and associated neurologic disorders(11.6% vs. 56.2%) between non-recurrent and recurrent group. 3) There were no significant differences on age at seizure onset(70.6 months vs. 58.5months), interval from seizure onset to start of treatment(9.5months vs. 6.6months), length of seizure free(49.7months vs 39.3months), abnormal EEG finding done just before withdrawal(23.2% vs. 25.0% ) between non-recurrent and recurrent group.
Child ; Electroencephalography ; Epilepsy* ; Gangwon-do ; Humans ; Nervous System Diseases ; Pediatrics ; Recurrence* ; Retrospective Studies ; Risk Factors* ; Seizures

Cyclic Neutropenia is a benign, unusual hematologic disorder characterized by regularly recurring episodes of severe neutropenia occurring approximately every 21 days. Beside neutrophils, monocytes, lymphocytes, platelets and reticulocytes all cycle with strict periodicity suggest that this disease should be viewed as cyclic hematopoiesis, not merely as cyclic neutropenia. During neutropenic periods, patients regularly experience aphthous stomatitis, fever, malaise, cervical lymphadenitis, cutaneous infections and occasional pneumonia and otitis media. The exact cause of cyclic neutropenia is unknown. But it is strongly suggested that cyclic neurtopenia is due to an abnormality in the regulation of early hematopoietic precursor cells. We have documented a case of cyclic neutropenia for a period of 2.5 years in a 11 year-old boy who had suffered from recurrent fever, stomatitis, gingival swelling, cervical lymphadenitis and skin infections at 3 weeks intervals since 5 years of age. A brief review of the related literatures is presented.
Child ; Fever ; Hematopoiesis ; Humans ; Lymphadenitis ; Lymphocytes ; Male ; Monocytes ; Neutropenia* ; Neutrophils ; Otitis Media ; Periodicity ; Pneumonia ; Reticulocytes ; Skin ; Stomatitis ; Stomatitis, Aphthous

OBJECTIVE: Recent studies demonstrated that soluble tumor DNA is found in the plasma of cancer patients, and some microsatellite alteration have been identified in ovarian carcinoma. The aim of study was to detect microsatellite abnormalities in the plasma of patients with ovarian carcinoma and to evaluate their efficacy as molecular screening or diagnostic tool for ovarian cancer. METHODS: In fifteen ovarian carcinoma patients, DNA was extracted from the plasma samples and microsatellite analysis was done with 11 microsatellite markers. RESULTS: All fifteen cases showed at least one tumor specific alteration in microsatellite analysis. The frequency of genetic alteration varies from 14.2% to 85.7%. Highly frequent tumor specfic alteration markers are D18S69 (85.7%), D10S215 (69.2%), D16S504 (66.7%), D8SNEFL (62.5%) and D11S1340 (60.0%). CONCLUSION: These results suggest that the mutation of tumor DNA can be detected in plasma of patients with ovarian carcinoma. LOH is more frequent event and the frequency of genetic alteration is relatively higher than that of previous reports.
DNA ; Humans ; Loss of Heterozygosity* ; Mass Screening ; Microsatellite Instability ; Microsatellite Repeats* ; Ovarian Neoplasms* ; Plasma*

Kawasaki disease is described by fever lasting five days or more, bilateral conjunctival injection, changes of lips and oral cavity, polymorphous exanthema, acute non-purulent cervical lymphadenopathy, and changes of extremities. Atypical Kawasaki disease is defined as fewer than 4 of 6 criteria described above including coronary artery abnormalities. Especially, atypical clinical manifestations of Kawasaki disease appear in infants younger than 6 months old of age. Thus we recommend echocardiography in early infancy who has prolonged fever in order to diagnose atypical Kawasaki disease and treat early. We have experienced three cases of atypical Kawasaki disease with coronary aneurysm who were admitted because of fever and revealed coronary aneurysm on echocardiography.
Coronary Aneurysm* ; Coronary Vessels ; Echocardiography ; Exanthema ; Extremities ; Fever ; Humans ; Infant ; Lip ; Lymphatic Diseases ; Mouth ; Mucocutaneous Lymph Node Syndrome*