BACKGROUND: Tuberculous lymphadenitis is the commonest form of extrapulmonary tuberculosis. The laboratory diagnosis of tuberculous lymphadenitis is based on the traditional method of the acid-fast stain and culture of discharge or lymph node. However, acid-fast stain lack sensitivity and specificity, and culture is time- consuming. Polymerase chain reaction is a rapid, sensitive and specific DNA amplification technique for the detection of Mycobacterium tuberculosis in sputum, pleural fluid, cerebrospinal fluid, or others. We evaluate the sensitivity and specificity of the polymerase chain reaction assay for the rapid diagnosis of tuberculous lymphadenitis. METHODS: This study included 50 patient with clinically suspected tuberculous lymphadenitis. We performed fine needle aspiration biopsies (FNAB) on head and neck lymph node. The DNA of the sample was purified by phenol/chloroform method. The nested PCR was performed with TB-CR kit (Bioneer, Korea), which an amplified an insertion sequence IS 6110 sequences. The PCR product was analyzed by agarose gel electrophoresis in the presence of ethidium bromide. RESULTS: Forty-five of the 50 clinically suspected specimens were PCR-positive, five specimens were negative. And one of the 10 negative specimens was positive. The sensitivity and specificity of the PCR was 90% and 90%, respectively. CONCLUSION: The polymerase chain reaction is a very sensitive and rapid method for rapid detection of M. tuberculosis in patients with tuberculous lymphadenitis.
Biopsy ; Biopsy, Fine-Needle ; Cerebrospinal Fluid ; Clinical Laboratory Techniques ; Diagnosis* ; DNA ; Electrophoresis, Agar Gel ; Ethidium ; Head ; Humans ; Lymph Nodes ; Lymphadenitis ; Mycobacterium tuberculosis ; Neck ; Nucleic Acid Amplification Techniques ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Sputum ; Tuberculosis ; Tuberculosis, Lymph Node*

Immunoglobulin G4-related disease (IgG4-RD) is an autoimmune disorder associated with fibroinflammatory conditions that can affect multiple organs. Hallmark histopathological findings of IgG4-RD include lymphocytic infiltration of IgG4-positive plasma cells, storiform fibrosis, and obliterative phlebitis. However, little is known about central nervous system involvement of IgG4-RD.Hypertrophic pachymeningitis (HP) has recently been reported as a manifestation of IgG4-RD, which may have previously been demonstrated in a significant percentage of idiopathic cases. Herein, we report a rare case of a 63-year-old male who presented with a scalp mass that mimicked a brain tumor. He was diagnosed with IgG4-related HP (IgG4-RP) after surgery. This case suggests that awareness of a possibility of IgG4-RP in patients with isolated scalp masses, even in the absence of systemic symptoms, is crucial. A combination of careful history taking, evaluation of serum IgG4-levels and imaging as an initial work-up, followed by tissue biopsy, is important for the differential diagnosis of IgG4-RP, malignancy, and other infectious diseases.

Background: and PurposeIn 2021, lung cancer in school food workers was first recognized as an occupational cancer. The classification of the carcinogenicity of cooking fumes by International Agency for Research on Cancer (IARC) was based on Chinese epidemiological data. This study aimed to determine the hazard levels of school cooking fumes in Korea. Materials and Methods: Based on public school cafeterias in one area, 25 locations were selected for the survey according to the number per school type, ventilation states, and environmental pre-assessments of cafeterias. Two inside cooking areas using a heat source and one outside cooking area were selected as control measurement points. Measurements of CO, CO2, polycyclic aromatic hydrocarbons (PAHs), and total volatile organic compounds (TVOCs), including benzene, formaldehyde, and particulate matter (PM10, PM2.5, PM1, respectively), were taken. The concentrations and patterns of each substance in the kitchens were compared with the outdoor air quality.ResultKnown carcinogens, such as the concentrations of PAHs, formaldehyde, TVOC (benzene), and particulate matter in school cooking fumes, were all detected at similar or slightly higher levels than those found outside. Additionally, substances were detected at relatively low concentrations compared to the Chinese cooking fumes reported in the literature. However, the short-term exposure to high concentrations of CO (or composite exposure with CO2) and PM2.5 in this study were shown. Conclusion The school cooking fumes in South Korea was a relatively less harmful than Chinese cooking fumes, however short-term, high exposure of toxic substances can cause a critical health effect.

No abstract available.
Animals ; DNA* ; Mice* ; Vaccination*

The Peutz-Jeghers syndrome has three cardinal features: gastrointestinal polypasis, mucocutaneous piginentation and autosomal dominant heredity. This syndrome is ciinically important because of the complication caused by the gastrointestinal ployp, leading to abdominal pain, gastrointestinal bleeding and intussusception. We experienced a case of Peutz-Jeghers syndrome who complained of dizziness, vague abdominal pain, melanin pigmentations of the lips, oral mucosa and digits and reported with the review of the literature.
Abdominal Pain ; Anemia* ; Dizziness ; Hemorrhage ; Heredity ; Intussusception* ; Lip ; Melanins ; Mouth Mucosa ; Peutz-Jeghers Syndrome ; Pigmentation

BACKGROUND/AIMS: We prepared a cross-cultural adaptation of the Behcet's Syndrome Activity Scale (BSAS) and evaluated its reliability and validity in Korea. METHODS: Fifty patients with Behcet's disease (BD) who attended the Rheumatology Clinic of Gachon University Gil Medical Center were included in this study. The first BSAS questionnaire was administered at each clinic visit, and the second questionnaire was completed at home within 24 hours of the visit. A Behcet's Disease Current Activity Form (BDCAF) and a Behcet's Disease Quality of Life (BDQOL) form were also given to patients. The test-retest reliability was analyzed by intraclass correlation coefficients (ICC). To assess the validity, the total BSAS score was compared with the BDCAF score, the patient/physician global assessment, and the BDQOL by Spearman rank correlation. RESULTS: Twelve males and 38 females were enrolled. The mean age was 48.5 years and the mean disease duration was 6.7 years. Thirty-eight patients (76.0%) returned the questionnaire by mail. For the test-retest reliability, the two assessments were significantly correlated on all 10 items of the BSAS questionnaire (p < 0.05) and the total BSAS score (ICC, 0.925; p < 0.001). The total BSAS score was statistically correlated with the BDQOL, BDCAF, and patient/physician global assessment (p < 0.01). CONCLUSIONS: The Korean version of BSAS is a reliable and valid instrument to measure BD activity.
Academic Medical Centers ; Adult ; Behcet Syndrome/*diagnosis/physiopathology/psychology ; Cost of Illness ; Cultural Characteristics ; Female ; Humans ; Male ; Middle Aged ; *Patient Reported Outcome Measures ; Predictive Value of Tests ; Quality of Life ; Reproducibility of Results ; Republic of Korea ; Severity of Illness Index

OBJECTIVE: This study measured the reliability of the Behcet's Disease Current Activity Form (BDCAF) questionnaire used as a patient self-report form. METHODS: A study was conducted among 63 patients with Behcet's disease who attended our rheumatology clinic. First, a physician administered a BDCAF questionnaire. Second, the patient completed a self-administered questionnaire at home within 24 hours of the visit. The test-retest reliability was analyzed using kappa tests. Kappa scores of >0.6 indicated good agreement. The BDCAF score was compared with the patient's/clinician's perception of disease activity and the Korean version of Behcet's Disease Quality of Life (BDQOL). RESULTS: The study included 17 males and 46 females. The mean age of participants was 47.7 years and the mean disease duration was 5.3 years at the first assessment. Fifty-three patients (84.1%) returned the questionnaires to us by mail. For test-retest reliability, good agreement was achieved with the items including headache, oral/genital ulceration, erythema, arthritis, and diarrhea with altered/frank blood per rectum; moderate agreement with skin pustules, arthralgia, and eye involvement; fair agreement with nausea/vomiting/abdominal pain, nervous system, and major vessel involvement. Significant associations were observed between BDCAF scores with the patient's/clinician's perception of disease activity and BDQOL (p<0.05). CONCLUSION: The BDCAF appears useful as a patient self-report instrument for assessment of disease status.
Arthralgia ; Arthritis ; Diarrhea ; Erythema ; Female ; Headache ; Humans ; Male ; Nervous System ; Postal Service ; Quality of Life ; Rectum ; Rheumatology ; Skin ; Ulcer

Cardiac contusion is an increasingly recognized entity in patients with nonpenetrating chest injury. Unifortunately, the diagnosis of cardiac trauma, particularly cardiac contusion, is imprecise and may be confounded by the presence of associated injuries, hypoxia, shock, and metabolic abnormalities. Symptomatic cardiac injury follwing blunt chest trauma is relatively rare, and valvular injury is even rarer. The valves most commonly affected are mitral and tricuspid. Although tricuspid regurgitations are usually asymptomatic and can resolve spontaneously, recent developments in echocardiography made possible the precise diagnosis of valvular injuries noninvasively, The authors report the case of tricuspid regurgitation incidentally detected by echocardiography in a construction worker who had suffered multiple fractures.
Anoxia ; Contusions ; Diagnosis ; Echocardiography* ; Humans ; Shock ; Thoracic Injuries ; Thorax ; Tricuspid Valve Insufficiency ; Tricuspid Valve*

Primary biliary cirrhosis (PBC) is occasionally developed in patients with rheumatic diseases, such as systemic sclerosis or Sjogren's syndrome. However, there are a few reports of overlap syndrome with PBC. The authors report a case of a 36 year-old female with PBC and overlap syndrome. Systemic sclerosis was diagnosed in 2007, and rheumatoid arthritis in 2010. Adalimumab stopped because of her pregnancy plan in January 2012. One month after delivery, she felt increased hand joint pain and fatigue. Laboratory findings were as follows: elevated AST, ALT, ALP, r-GTP and positive anti-mitochondrial antibody. Histology of a liver biopsy revealed moderate porto-periportal and mild lobular inflammation with bile duct inflammation, which was consistent with PBC. She was treated with prednisolone and UDCA (urosodeoxycholic acid), but her disease was not controlled. From May 2013, she has been treated with adalimumab. Her arthritis was improved and liver function test normalized up until now.
Adalimumab ; Arthralgia ; Arthritis ; Arthritis, Rheumatoid ; Bile Ducts ; Biopsy ; Fatigue ; Female ; Glycogen Storage Disease Type VI ; Hand ; Humans ; Inflammation ; Liver ; Liver Cirrhosis, Biliary* ; Liver Function Tests ; Prednisolone ; Pregnancy ; Rheumatic Diseases ; Scleroderma, Systemic ; Sjogren's Syndrome

BACKGROUND: Chlamydia trachomatis is currently classified into 15 serovars (A, B, Ba, C, D, E, F, G, H, I, J, K, L1, L2, L3) and a large number of serovariants. Typing of C. trachomatis serovars has generally been performed by the MOMP (major outer membrane protein) serotyping method, which requires a large panel of polyclonal and monoclonal antibodies. Recently the PCR was successfully applied to the genotyping of different C. trachomatis serovars by means of restriction fragment length polymorphism (RFLP) analysis and direct sequencing of amplified omp1 DNA. The objective of this study was to evaluate the serotyping of C. trachomatis by PCR-FLP and to determine the serovars of C. trachomatis urogenital isolates. METHODS: The 15 reference strains of C. trachomatis and 27 clinical isolates were analyzed by PCR-FLP. The C. trachomatis omp1 gene was amplified by PCR. For serotyping by RFLP analysis, the omp1 PCR products were digested with AluI and were electrophoresed through a 7% polyacrylamide gel with ethidium bromide staining. If necessary, the PCR products were analyzed with HinfI, a combination of EcoRI and DdeI, or CfoI. RESULTS: In serotyping of 15 reference strains of C. trachomatis, serovars A, B, Ba, E, F, G, K, and L2 were clearly identified after AluI digestion. However serovars C, H, I, J, L3 and serovars D, L1 were respectively identical patterns after AluI digestion. Serovars C and J and serovars D and L1 were further discriminated by a second step of enzyme digestion with HinfI. Serovar H, I, and L3 were distinguished by enzyme digestion with EcoRI and DdeI. In serotyping of C. trachomatis from 27 urogenital isolates, 25 isolates were clearly typed. Nine were typed as serovar E, 8 were typed as serovar D, 6 were typed as F, 2 were typed as serovar H. Two isloates showed unidentifiable RFLP pattern which was not in accordance with any of the existing C. trachomatis prototypes. CONCLUSIONS: PCR-FLP analysis is a rapid, simple, and powerful tool for differentiating serovars of C. trachomatis. Therefore, this approach is recommended for future epidemiological studies of C. trachomatis. And the serovar E, D, and F are the most prevalent types found in urogenital specimens, representing 92% of those investigated.
Antibodies, Monoclonal ; Chlamydia trachomatis* ; Chlamydia* ; Digestion ; DNA ; Ethidium ; Membranes ; Polymerase Chain Reaction* ; Polymorphism, Restriction Fragment Length* ; Serotyping*