There are several antigenic variants of Orientia tsutsugamushi. The 56-kDa type-specific antigen (TSA) is responsible for the antigenic variation. Nucleotide sequences of the 56-kDa TSA obtained from 44 eschar samples of Korean scrub typhus patients and from 40 representative strains retrieved from the GenBank database were analyzed phylogenetically. Clinical patient data were assessed based on the genotyping results. Of the 44 nucleotide sequences, 32 (72.7%) clustered with the Boryong genotype, which is the major genotype in Korea. Eleven nucleotide sequences (25%) clustered with the Kawasaki genotype, not identified in Korea until 2010. One nucleotide sequence was consistent with the Karp genotype. The clinical course of the patients infected with each genotype showed no differences. Diagnostic performance of the immunofluorescence assay (IFA) using the 56-kDa TSA from Gilliam, Karp and Boryong as test antigens were not different for the Boryong and Kawasaki genotypes. Although Boryong is still the predominant genotype, the results suggest that Kawasaki genotype is quite prevalent in Chungbuk province of Korea.
Aged ; Bacterial Proteins/*genetics/metabolism ; Base Sequence ; DNA, Bacterial/analysis ; Databases, Genetic ; Female ; Genotype ; Humans ; Male ; Middle Aged ; Open Reading Frames ; Orientia tsutsugamushi/*classification/isolation & purification ; Phylogeny ; Republic of Korea ; Scrub Typhus/diagnosis/metabolism/*microbiology ; Sequence Analysis, DNA

There are several antigenic variants of Orientia tsutsugamushi. The 56-kDa type-specific antigen (TSA) is responsible for the antigenic variation. Nucleotide sequences of the 56-kDa TSA obtained from 44 eschar samples of Korean scrub typhus patients and from 40 representative strains retrieved from the GenBank database were analyzed phylogenetically. Clinical patient data were assessed based on the genotyping results. Of the 44 nucleotide sequences, 32 (72.7%) clustered with the Boryong genotype, which is the major genotype in Korea. Eleven nucleotide sequences (25%) clustered with the Kawasaki genotype, not identified in Korea until 2010. One nucleotide sequence was consistent with the Karp genotype. The clinical course of the patients infected with each genotype showed no differences. Diagnostic performance of the immunofluorescence assay (IFA) using the 56-kDa TSA from Gilliam, Karp and Boryong as test antigens were not different for the Boryong and Kawasaki genotypes. Although Boryong is still the predominant genotype, the results suggest that Kawasaki genotype is quite prevalent in Chungbuk province of Korea.
Aged ; Bacterial Proteins/*genetics/metabolism ; Base Sequence ; DNA, Bacterial/analysis ; Databases, Genetic ; Female ; Genotype ; Humans ; Male ; Middle Aged ; Open Reading Frames ; Orientia tsutsugamushi/*classification/isolation & purification ; Phylogeny ; Republic of Korea ; Scrub Typhus/diagnosis/metabolism/*microbiology ; Sequence Analysis, DNA

Finite Element Analysis ; Humans ; Mandible ; Stress, Mechanical

OBJECTIVES: Hearing loss disrupts the balance of auditory-somatosensory inputs in the cochlear nucleus (CN) of the brainstem, which has been suggested to be a mechanism of tinnitus. This disruption results from maladaptive auditory-somatosensory plasticity, which is a form of axonal sprouting. Axonal sprouting is promoted by transforming growth factor (TGF)-β signaling, which can be inhibited by losartan. We investigated whether losartan prevents maladaptive auditory-somatosensory plasticity after hearing loss. METHODS: The study consisted of two stages: determining the time course of auditory-somatosensory plasticity following hearing loss and preventing auditory-somatosensory plasticity using losartan. In the first stage, rats were randomly divided into two groups: a control group that underwent a sham operation and a deaf group that underwent cochlea ablation on the left side. CNs were harvested 1 and 2 weeks after surgery. In the second stage, rats were randomly divided into either a saline group that underwent cochlear ablation on the left side and received normal saline or a losartan group that underwent cochlear ablation on the left side and received losartan. CNs were harvested 2 weeks after surgery. Hearing was estimated with auditory brainstem responses (ABRs). Western blotting was performed for vesicular glutamate transporter 1 (VGLUT1), reflecting auditory input; vesicular glutamate transporter 2 (VGLUT2), reflecting somatosensory input; growth-associated protein 43 (GAP-43), reflecting axonal sprouting; and p-Smad2/3. RESULTS: Baseline ABR thresholds before surgery ranged from 20 to 35 dB sound pressure level. After cochlear ablation, ABR thresholds were higher than 80 dB. In the first experiment, VGLUT2/VGLUT1 ratios did not differ significantly between the control and deaf groups 1 week after surgery. At 2 weeks after surgery, the deaf group had a significantly higher VGLUT2/VGLUT1 ratio compared to the control group. In the second experiment, the losartan group had a significantly lower VGLUT2/VGLUT1 ratio along with significantly lower p-Smad3 and GAP-43 levels compared to the saline group. CONCLUSION: Losartan might prevent axonal sprouting after hearing loss by blocking TGF-β signaling thereby preventing maladaptive auditory-somatosensory plasticity.
Animals ; Axons ; Blotting, Western ; Brain Stem ; Cochlea ; Cochlear Nucleus ; Evoked Potentials, Auditory, Brain Stem ; GAP-43 Protein ; Hearing Loss ; Hearing ; Losartan ; Plastics ; Rats ; Tinnitus ; Transforming Growth Factors ; Vesicular Glutamate Transport Protein 1 ; Vesicular Glutamate Transport Protein 2

Mucocele-like tumor of the breast is a rare neoplasm and only a few cases of mucocele-like tumor have been reported on in Korea. These lesions were originally considered as being benign when they were first described, but now it is believed they can be both malignant and benign, and it is even possible that they are early lesions of mucinous carcinoma. We describe here both the mammographic and sonographic findings in a patient with bilateral mucocele-like tumors that were associated with ductal carcinoma in situ and mucinous carcinoma.
Adenocarcinoma, Mucinous* ; Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Humans ; Korea ; Mucins* ; Ultrasonography

BACKGROUND/AIMS: Kidney transplantation (KT) reportedly provides a significant survival advantage over dialysis in diabetic patients. However, KT outcome in diabetic patients compared with that in non-diabetic patients remains controversial. In addition, owing to recent improvements in the outcomes of KT and management of cardiovascular diseases, it is necessary to analyze outcomes of recently performed KT in diabetic patients. METHODS: We reviewed all diabetic patients who received living donor KT between January 2008 and December 2011. Each patient was age- and sex-matched with two non-diabetic patients who received living donor KT during the same period. The outcomes of living donor KT were compared between diabetic and non-diabetic patients. RESULTS: Among 887 patients, 89 diabetic patients were compared with 178 non-diabetic patients. The incidence of acute rejection was not different between the diabetic and non-diabetic patients. Urinary tract infection and other infections as well as cardiovascular events occurred more frequently in diabetic patients. However, diabetes, cardiovascular disease, and infection were not significant risk factors of graft failure. Late rejection (acute rejection after 1 year of transplantation) was the most important risk factor for graft failure after adjusting for diabetes mellitus (DM), human leukocyte antigen mismatch, rejection and infection (hazard ratio, 56.082; 95% confidence interval, 7.169 to 438.702; p < 0.001). Mortality was not significantly different between diabetic and non-diabetic patients (0 vs. 2, p = 0.344 by log-rank test). CONCLUSIONS: End-stage renal disease patients with DM had favorable outcomes with living donor kidney transplantation.
Cardiovascular Diseases ; Diabetes Mellitus ; Dialysis ; Humans ; Incidence ; Kidney Failure, Chronic ; Kidney Transplantation* ; Kidney* ; Leukocytes ; Living Donors* ; Mortality ; Risk Factors ; Transplants ; Urinary Tract Infections

PURPOSE: To ascertain the incidence of proximal humeral epiphyseal ossification centers, as shown on chest radiographs, in neonates and infants. MATERIALS AND METHODS: The distribution of corrected age(CA) of the infantswas from 24 weeks of gestational age to 6 months of postnatal age. They were obtained from inborn and outborn infants without developmental problems. Proximal humeral epiphyseal ossification centers were evaluated by two radiologists from a total of 440 chest radiographs. Of these, 196 were of the female chest and 244 were of themale. Corrected ages based on postnatal age are expressed as weeks before two months of age and as months after two months of age. The ossified or nonossified epiphyses of the humeral heads were plotted against corrected age. From these graphs, the percentages of ossification according to their corrected age was observed. RESULTS: 37weeks of corrected age in which 9.1%(1/11) was ossified was the earliest age of humeral epiphyseal ossification in the female. While 35 weeks of CA in which 6.3%(1/16) was ossified was the earliest age in the male. In full-term neonates(=40 weeks of CA), 20%(6/30) of epiphysis was ossified in the female and 23.3%(7/30) in the male. The female group of 43-44 weeks of corrected age showed ossification of 50% and the male group of 44-45 weeks of corrected age showed ossification of 50%. By five months of corrected age, 100% of epiphyses, both in the female and in the male, were ossified. CONCLUSION: Humeral ossification centers are seen from 35-37 weeks of correctedage. By five months of age, all humeral epiphyses are ossified.
Epiphyses ; Female ; Gestational Age ; Humans ; Humeral Head ; Incidence* ; Infant* ; Infant, Newborn* ; Male ; Radiography, Thoracic ; Thorax

Betula platyphylla var. japonica (Betulaceae), also known as Asian white birch, is an endemic medicinal tree, the bark of which has been used in Chinese traditional medicine for the treatment of various inflammatory diseases. In our continuing search for bioactive compounds from Korean natural resources, a phytochemical investigation of the bark of B. platyphylla var. japonica led to the isolation of 7-oxo-β-sitosterol (1) and soyacerebroside I (2) from its ethanol extract as main components by liquid chromatography (LC)/mass spectrometry (MS)-based analysis. The structures of isolates were identified by comparison of ¹H and ¹³C nuclear magnetic resonance spectroscopic data and physical data with the previously reported values and LC/MS analyses. To the best of our knowledge, this is the first study to demonstrate that the isolated compounds, 7-oxo-β-sitosterol and soyacerebroside I, were isolated in B. platyphylla var. japonica. We examined the effects of the isolates on the regulation of adipocytes and osteoblast differentiation. These isolates (1 and 2) produced fewer lipid droplets compared to the untreated negative control in Oil Red O staining of the mouse mesenchymal stem cell line without altering the amount of alkaline phosphatase staining. The results demonstrated that both compounds showed marginal inhibitory effects on adipocyte differentiation but did not affect osteoblast differentiation.
Adipocytes ; Alkaline Phosphatase ; Animals ; Asian Continental Ancestry Group ; Betula ; Chromatography, Liquid ; Ethanol ; Humans ; Lipid Droplets ; Magnetic Resonance Spectroscopy ; Medicine, Chinese Traditional ; Mesenchymal Stromal Cells ; Mice ; Natural Resources ; Osteoblasts ; Spectrum Analysis ; Trees

BACKGROUND: This study determined the dose of remifentanil to use during insertion of a Classic(TM) laryngeal mask airway (LMA, The Laryngeal Mask Co., Nicosia, Cyprus) in elderly patients during emergency airway management when combined with a single dose of propofol. METHODS: Patients aged 65-80 years were enrolled. Anesthesia was induced with propofol 1 mg/kg, and then a blinded dose of remifentanil was infused over 30 s after confirming the patient's loss of consciousness. The dose of remifentanil was determined using Dixon's up-and-down method, starting at 0.5 microg/kg (a step size of 0.1 microg/kg). Insertion of the LMA was attempted 60 s after loss of consciousness. RESULTS: In total, 23 patients were recruited and the mean age +/- standard deviation was 72 +/- 3 years. The effective dose for successful LMA insertion in 50% of the patients (ED50) was 0.20 +/- 0.05 microg/kg. No patient needed more than 0.3 microg/kg. CONCLUSIONS: Remifentanil 0.20 +/- 0.05 microg/kg with propofol 1 mg/kg resulted in excellent LMA insertion in 50% of elderly patients without significant hemodynamic changes during emergency airway management.
Aged* ; Airway Management* ; Anesthesia ; Emergencies* ; Hemodynamics ; Humans ; Laryngeal Masks* ; Propofol* ; Unconsciousness

This study was to clarify whether Behcet's disease (BD) could be classified into the spondyloarthropathy (SpA) complex. It was undertaken on 58 patients with BD (BD group), 56 patients with SpA (SpA group), and 3 patients who concurrently satisfied the criteria for BD and SpA (BDSpA group). The clinical parameters and known susceptible HLA antigens were compared between BD group and SpA group. In addition, 3 patients in BDSpA group were reviewed. The prevalence of definitive sacroiliitis (SI) in BD group and SpA group was 46.4% and 5.2%, respectively. However, none had a definitive SI in healthy controls. Enthesitis was observed in 3.4% of BD group and in 50% of SpA group. The patterns of eye involvement were different between these two groups. HLA-B27 was negative in all 49 patients of BD group, whereas it was positive in 67.9% of SpA group. The prevalence of HLA-B51 was 51.7% in BD group, and that in SpA group was 21.4%. One patient in BDSpA group was considered to have concurrent BD and ankylosing spondylitis (AS). Another patient was closer to AS, and the third to BD. Conclusively, it seems that BD could not be classified into the SpA complex.
Adult ; Behcet Syndrome/*classification/immunology/pathology ; Eye/pathology ; Female ; HLA-B Antigens/analysis/immunology ; HLA-B27 Antigen/analysis/immunology ; Humans ; Lumbar Vertebrae/pathology/radiography ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pelvis ; Radioactive Tracers ; Sacroiliac Joint/pathology/radiography ; *Spondylarthritis/immunology/pathology ; Tomography, Emission-Computed, Single-Photon