29 isoniazid (INH) resistant isolated strains and INH sensitive reference strain (H37Rv) of Mycobacterium tuberculosis were analysed by polymerase chain reaction-single strand conformational polymorphism (PCR-SSCP) and NciI restriction mapping for the detection of mutations in katG gene and inhA gene. The katG gene was divided into 3 parts (Akat, Bkat, Ckat; each part is about 800 bp) and amplified, inhA gene was amplified as a whole. Each of the amplified 800 bp DNA was digested into small fragments of less than 400 bp with restriction enzymes for the direct PCR-SSCP analysis. Firstly, 10 strains were analysed. All the 10 isolates showed clearly distinct SSCP patterns in Bkat from that of the reference strain, but only two isolates showed distinct SSCP patterns in Akat, and no isolated strain showed any distinct SSCP patterns in Ckat. 10 isolates also showed distinct SSCP patterns in inhA. NciI restriction mapping of Bkat showed mutation in codon 463 in 7 strains among 10 isolated strains. With these results an early detection strategy for the INH resistant M. tuberculosis was applied to the rest of 19 isolated INH resistant strains. Firstly, isolates were screened by Ncsl mapping in Bkat, and 13 strains showed mutations in codon 463. Secondly, the rest of 6 INH resistant isolates were analysed by PCR-SSCP with restriction enzyme digestion (PCR-SSCP-RE) in Bkat, and all the strains showed distinct SSCP patterns from that of the INH sensitive reference strain. This proved our strategy as effective and economic and time saving method in early detection of INH resistant M. tuberculosis.
Codon ; Diagnosis* ; Digestion ; DNA ; Isoniazid* ; Korea* ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymorphism, Single-Stranded Conformational ; Restriction Mapping ; Tuberculosis

Clostridium perfringens is an anaerobe responsible for a wide range of diseases in animals and humans. Symptoms associated with C. perfringens food poisoning are caused by enterotoxin expressed only during sporulation of C. perfringens. It has been known that only 6% of global C. perfringens isolates carry the enterotoxin gene. We found 2 strains of enterotoxigenic C. perfringens out of 33 strains isolated from various sources in Korea using PCR. It was also found that these two strains were both type A that were strongly associated with food poisoning by checking the presence of four major lethal toxins (a-, B-, e-, l-toxin) using PCR. These results suggest that foodborne illness caused by C. perfringens may be common in Korea and that public education is necessary to prevent contamination of foods by this organism.
Animals ; Clostridium perfringens* ; Clostridium* ; Education ; Enterotoxins* ; Foodborne Diseases ; Humans ; Korea* ; Polymerase Chain Reaction

Hypertension is a serious health problem due to high frequency and concomitant other diseases including cardiovascular and renal dysfunction. Olmesartan cilexetil is a new antihypertensive drug associated with angiotensin II receptor antagonist. This study was conducted to evaluate the mutagenicity of olmesartan cilexetil by bacterial reverse mutation test using Salmonella typhimurium (TA100, TA1535, TA98, and TA1537) and Escherichia coli (WP2 uvrA). At the concentrations of 0, 62, 185, 556, 1667, and 5000 microg/plate, olmesartan cilexetil was negative in both Salmonella typhimurium and Escherichia coli regardless of presence or absence of metabolic activation system (S9 mix). These results demonstrate that olmesartan cilexetil does not induce bacterial reverse mutation.
Biotransformation ; Escherichia coli ; Hypertension ; Imidazoles ; Receptors, Angiotensin ; Salmonella typhimurium ; Tetrazoles

BACKGROUND/AIMS: Ambulatory blood pressure (BP) monitoring has been widely recommended for evaluating the status of BP, but is lacking in practicality. Determination of the specific time points for BP measurement that are representative of 24-hour mean BP could be useful and convenient in hypertensive patients with chronic kidney disease (CKD). METHODS: A total of 1,317 patients for whom 24-hour ambulatory BP monitoring was performed were enrolled in a multicenter study on hypertensive CKD. We analyzed the time points at which systolic blood pressure (SBP) values exhibited the smallest differences from 24-hour mean SBP (mSBP). We included office mSBP and analyzed the relationships between SBPs at the office and the time points with the smallest differences from 24-hour mSBP using several methods. RESULTS: The time points with the smallest differences from 24-hour mSBP were 7:00 AM, 2:00 PM, and 9:30 PM. In regression analysis, SBPs at 7:00 AM and 9:30 PM were better correlated with 24-hour mSBP than SBPs at 2:00 PM and the office. The proportions of patients with SBPs within 30% of 24-hour mSBP were higher at 7:00 AM and 9:30 PM. The best consistency between the uncontrolled hypertensive groups, defined as > or = 135 mmHg of 24-hour mSBP and higher values of SBPs corresponding to 135 mmHg of 24-hour mSBP, were observed at the 7:00 AM and 9:30 PM time points. CONCLUSIONS: The specific time points for SBPs that correlated well with 24-hour mSBP in hypertensive CKD patients were 7:00 AM and 9:30 PM.
Adult ; Aged ; *Blood Pressure ; Blood Pressure Monitoring, Ambulatory/*methods ; Circadian Rhythm ; Cross-Sectional Studies ; Female ; Humans ; Hypertension/*diagnosis/physiopathology ; Male ; Middle Aged ; Office Visits ; Predictive Value of Tests ; Prospective Studies ; Renal Insufficiency, Chronic/*diagnosis/physiopathology ; Republic of Korea ; Time Factors ; Young Adult

Genetically modified (GM) soybean (carrying the EPSPS transgene) is the most common GM food in Korea. In order to assess whether genetic modification increases the allergenic risk of soybeans, the allergenicity and IgE-reactive components of wild-type and GM soybean extracts were compared in allergic adults who had been sensitized to soybeans. We enrolled 1,716 adult allergy patients and 40 healthy, non-atopic controls. Skin prick tests and IgE enzyme linked immunosorbent assays (ELISAs) were performed using wild-type and GM soybean extracts, along with other common inhaled allergens. The specificities of serum IgE antibodies from allergic patients and the identities of the IgE-reactive components of the soybean extracts were compared using ELISA inhibition testing, 2-dimensional gel electrophoresis, and IgE immunoblotting. To evaluate the effects of digestive enzymes and heat treatment, the soybean extracts were heated or pre- incubated with or without simulated gastric and intestinal fluids. The IgE sensitization rates to wild-type and GM soybeans were identical (3.8% of allergic adults), and circulating IgE antibodies specific for the two extracts were comparable. The results of the ELISA inhibition test, SDS-PAGE, and IgE immunoblotting showed a similar composition of IgE-binding components within the wild-type and GM extracts, which was confirmed using two-dimensional gel electrophoresis, IgE immunoblotting, and amino acid sequencing. None of the subjects had a positive response to purified EPSPS protein in the skin prick test, ELISA, or IgE immunoblot analysis. These findings suggest that the IgE sensitization rate to GM soybean extracts is identical to that of wild-type soybean extracts in adult allergy patients. In addition, based on both in vivo and in vitro methods, the allergenicity of wild type and GM soybean extracts was identical.
Soybeans/*immunology ; Skin Tests ; Protein Structure, Tertiary ; *Plants, Genetically Modified ; Middle Aged ; Immunoglobulin E/blood/chemistry ; Immunoblotting ; Humans ; Food Hypersensitivity/etiology/*immunology ; Food/*adverse effects ; Enzyme-Linked Immunosorbent Assay ; Electrophoresis, Gel, Two-Dimensional ; *Crops, Agricultural ; Allergens/*immunology ; Adult ; Adolescent

A 77-year-old man visited our hospital complaining of aggravated exertional chest pain. He was diagnosed with syndrome X 7 years ago and underwent medical treatment in a regional hospital. Coronary angiography and echocardiography did not show any significant abnormalities. On the seventh in-hospital day, cardiogenic shock developed and echocardiography showed a dilated left ventricular (LV) cavity and severe LV systolic dysfunction. We thus inserted an intra-aortic balloon pump for hemodynamic support and were forced to maintain it because of weaning failure several times. Finally, heart transplantation was the decided necessary procedure. After successful heart transplantation, the biopsy specimen revealed a wild-type transthyretin deposition indicating senile systemic amyloidosis in the intramuscular coronary vessels and interstitium. Cardiac biopsy at the 4-year follow-up showed no recurrence of amyloid deposition.
Aged ; Amyloidosis ; Angina Pectoris ; Biopsy ; Cardiomyopathy, Dilated ; Chest Pain ; Coronary Angiography ; Coronary Vessels ; Echocardiography ; Follow-Up Studies ; Heart Transplantation ; Hemodynamics ; Humans ; Microvascular Angina ; Plaque, Amyloid ; Prealbumin ; Recurrence ; Shock, Cardiogenic ; Weaning

Primary malignant pericardial mesothelioma is a very rare and highly aggressive tumor with a poor prognosis. Here, we present the case of a 71-year-old man with symptoms of chest discomfort and exertional dyspnea starting 1 week prior to admission. We identified a pericardial mass using transthoracic echocardiography, but could not diagnose the patient using other multimodal imaging approaches and effusion cytology. Findings on contrast cardiac computed tomography (CT) and magnetic resonance imaging (MRI) were more consistent with angiosarcoma than malignant mesothelioma. Ultimately, the patient was diagnosed with malignant pericardial mesothelioma, based on immunohistochemical staining of the tumor tissue. In recent years, several cases have reported the efficacy of chemotherapy in malignant mesothelioma. Thus, we suggest that accurate diagnosis of pericardial tumors with pathology may have a profound impact on the final prognosis.
Aged ; Dyspnea ; Echocardiography ; Heart Neoplasms ; Hemangiosarcoma ; Humans ; Magnetic Resonance Imaging ; Mesothelioma ; Pericardial Effusion ; Prognosis ; Thorax

BACKGROUND: Hyperkalemia, one of life threatening medical emergencies, has had its prognosis and treatment determined clinically based on the findings of EKG. To date, there hasn't been enough data on the effect of very early EKG features of hyperkalemia on the long-term outcome of treatment. Therefore, we have conducted this study to suggest possible treatment guideline for hyperkalemia by analyzing the correlations between initial parameters, treatment methods and treatment outcomes. METHODS: We reviewed retrospectively the medical records of 58 patients with hyperkalemia who visited the Hanyang University Kuri Hospital from May 1995 to April 2000. We examed underlying diseases, electrolytes, regular hemodialysis, hemodialysis trials, clinical and ECG findings(at initial and recovery state). RESULTS: High systolic pressure seems to be significantly correlated with high recovery rate. Subjects with unique EKG finding of hyperkalemia were more likely to have higher serum potassium level and death rate than those without unique EKG finding. However, this group has shown improved recovery rate after undergoing hemodialysis. Serum potassium level of hyperkalemia phase does not correlate with final outcomes and EKG findings. Over 80 percent of the hyperkalemic subjects are accompanied with renal failure, and there was significant improvement in the survival rate in renal failure subjects whom had undergone hemodialysis. CONCLUSION: In hyperkalemia, the EKG has the importance in diagnosis, severity classification and treatment choice. However, prognosis of the hyperkalemia does not rely solely on the EKG itself but rather on the appropriate individualized treatment including hemodynamic stabilization and hemodialysis. Therefore, prompt and adequate treatment based on early speculation upon possible etiologic candidates, EKG, and general condition may lead to recovery from the hyperkalemia, including critical conditions such as conduction disorder and severe arrhythmia.
Arrhythmias, Cardiac ; Blood Pressure ; Classification ; Diagnosis ; Electrocardiography* ; Electrolytes ; Emergencies ; Hemodynamics ; Humans ; Hyperkalemia* ; Medical Records ; Mortality ; Potassium ; Prognosis* ; Renal Dialysis ; Renal Insufficiency ; Retrospective Studies ; Survival Rate

BACKGROUND: Hyperkalemia, one of life threatening medical emergencies, has had its prognosis and treatment determined clinically based on the findings of EKG. To date, there hasn't been enough data on the effect of very early EKG features of hyperkalemia on the long-term outcome of treatment. Therefore, we have conducted this study to suggest possible treatment guideline for hyperkalemia by analyzing the correlations between initial parameters, treatment methods and treatment outcomes. METHODS: We reviewed retrospectively the medical records of 58 patients with hyperkalemia who visited the Hanyang University Kuri Hospital from May 1995 to April 2000. We examed underlying diseases, electrolytes, regular hemodialysis, hemodialysis trials, clinical and ECG findings(at initial and recovery state). RESULTS: High systolic pressure seems to be significantly correlated with high recovery rate. Subjects with unique EKG finding of hyperkalemia were more likely to have higher serum potassium level and death rate than those without unique EKG finding. However, this group has shown improved recovery rate after undergoing hemodialysis. Serum potassium level of hyperkalemia phase does not correlate with final outcomes and EKG findings. Over 80 percent of the hyperkalemic subjects are accompanied with renal failure, and there was significant improvement in the survival rate in renal failure subjects whom had undergone hemodialysis. CONCLUSION: In hyperkalemia, the EKG has the importance in diagnosis, severity classification and treatment choice. However, prognosis of the hyperkalemia does not rely solely on the EKG itself but rather on the appropriate individualized treatment including hemodynamic stabilization and hemodialysis. Therefore, prompt and adequate treatment based on early speculation upon possible etiologic candidates, EKG, and general condition may lead to recovery from the hyperkalemia, including critical conditions such as conduction disorder and severe arrhythmia.
Arrhythmias, Cardiac ; Blood Pressure ; Classification ; Diagnosis ; Electrocardiography* ; Electrolytes ; Emergencies ; Hemodynamics ; Humans ; Hyperkalemia* ; Medical Records ; Mortality ; Potassium ; Prognosis* ; Renal Dialysis ; Renal Insufficiency ; Retrospective Studies ; Survival Rate

BACKGROUND: It has been found that Helper T cells in the peripheral blood are decreased in the cell mediated immunity in the pulmonary tuberculosis But it has not been confirmed yet that only decrease in number of cells which has phenotype in the peripheral blood is defined to decrease in cell mediated immunity. The immunocytochemical study was performed to observe the change of the percentage of T-lymphocytes with their subsets and activated T cells in the peripheral blood of pulmonary tuberculosis and to know how many T cells would be activated, relative to resting cells in the peripheral blood. METHODS: The peripheral blood obtained from twenty two patients and ten healthy controls were smeared on the gelatin coated slide glass prepared for of mononuclear cells. The double bridge technique of alkaline phosphatase-antialkaline phosphatase(APAAP) method was used. As the primary antibodies, T1(anti-human T cell), T4(anti-human helper/inducer T cells) and T8(anti-human supressor/cytotoxic T cell) antibodies and interleukin-2 receptor (for early activated T cell),very late activation antigen (for activated cytotoxic T cell), T cell lineage specific activation antigen monoclonal actibodies were used. RESULTS: 1) There were significantly decrease in the absolute number of T4(+) cells but significantly increase of T8(+) cells in the peripheral blood of pulmonary tuberculosis (p<0.05). 2) The percentage of T4(+) cells showed significantly decrease in pulmonary tuberculosis but T8 (+)cells significantly increase(p<0.05). T4(+)/T8 (+) ratio showed significantly decrease in the peripheral blood of the pulmonary tuberculosis(p <0.05) 3) There were significantly increase in the absolute number of variable stages of activated T cells in the peripheral blood of the pulmonary tuberculosis(p<0.05). 4) The percentage of IL-2R, VLA-1, TLiSA were 6.45+1.56%, 7.64+1.34*, 10.45+1.16% in order which showed significantly increase in the peripheral blood of the pulmonary tuberculosis(p <0.05). CONCLUSION: We speculate that only a few percentage of T lymphocyte is activated in cell mediated immunity in pulmonary tuberculosis.
Antibodies ; Cell Lineage ; Gelatin ; Glass ; Humans ; Immunity, Cellular ; Integrin alpha1beta1 ; Interleukin-2 ; Lymphocytes ; Phenotype ; T-Lymphocytes* ; T-Lymphocytes, Helper-Inducer ; Tuberculosis, Pulmonary*