BACKGROUND: The diagnosis of diseases caused by nontuberculous mycobacteria (NTM) is difficult, because NTM are prevalent in the environment such as soil and water, and because they have fastidious properties. In this study we investigated clinical isolates of NTM for their distribution pattern and accurate species identification. METHODS: We selected presumptive NTM isolates negative for probe hybridization for M. tuberculosis complex, cultured in a third referral hospital from 21 January 2003 to 20 January 2004. Ninety seven-isolates were identified to the species level by direct sequencing of fragments of 16S rRNA, hsp65 and rpoB genes. A total of 120 isolates were studied for the distribution analysis. RESULTS: Frequently identified NTM species were M. avium (30.8%), M. intracellulare (23.3%) and M. abscessus (18.3%). Others were M. gordonae, M. senegalense, M. fortuitum, M. peregrinum, M. kansasii, M. terrae complex, M. lentiflavum, M. chelonae, and M. szulgai. Three M. tuberculosis complex (2.5%) were also identified among the presumptive NTM isolates. The identification rate by sequencing of 16S rRNA, rpoB, and hsp65 were 65%, 82% and 87%, respectively. The hsp65 or rpoB gene was more efficient than 16S rRNA for the identification of NTM by sequencing. CONCLUSIONS: Some NTM are increasingly considered to be the causative organisms in clinical diseases. Thus, direct sequencing could be adapted to routine work of clinical laboratories for accurate identification of NTM to the species level.
Diagnosis ; DNA-Directed RNA Polymerases* ; Gordonia Bacterium ; Heat-Shock Proteins* ; Nontuberculous Mycobacteria* ; Referral and Consultation ; RNA* ; RNA, Ribosomal, 16S* ; Sequence Analysis* ; Soil ; Tuberculosis

A clinico-pathological study on the true skin appendage tumors was carried on the accumulated cases during pat 11 years from 1976 to 1986 years in the Department of Pathology, Seoul National University Hospital. The results was as follows; 1) Among various benign skin appendage tumors pilomatricoma was the most common benign tumor consisting of 72 out of 244 cases (30.1%), followed by dermoid cyst 48 cases (20.0%), steatocystoma multiplex 37 cases (15.5%), syringoma 33 cases (13.8%) and trichilemmal cyst 19 cases (0.8%). Other benign skin appendage tumors were rarely noted under 3%. Sebaceous carcinoma was most common among malignant skin appendage tumors and no malignant tumor of sweat gland origin was noted. 2) The sex ratio of male to female of the pilomatricoma was 1 : 2.6 and on the face, neck, and extremeties in 1st and 2nd decades. The sex ratio of dermoid cyst was 1 : 1.2 on the face in 1st decade. The sex ratio of steatocystoma multiplex was 1 : 1.9 and on the trunk in 3rd decade. The sex ratio of syringoma was 1 : 7 and on the face in 5th decade. The sex ratio of trichilemmoma was 1 : 1.6 and on the trunk in 5th decade. Other tumors were not avaiable for analysis because of small number. The sex ratio of sebaceous carcinoma was 1 : 2 and on the eyelid in 6th decade
Female ; Male ; Humans ; Cysts

Members of the genus Hantavirus are the etiologic agents of hemorrhagic fever with renal syndrome (HFRS), the diagnosis of which is somewhat difficult because several diseases share similar early clinical presentations such as fever and petechia. In Korea, Hantaan virus and Seoul virus are the causative organisms of HFRS, and the infection caused by Seoul virus is milder than that caused by Hantaan virus. We report a 44-year-old woman, who visited our hospital due to general weakness, fever, myalgia, facial edema and diarrhea. She was diagnosed with HFRS caused by Seoul virus. The antibody against Hantaan virus was positive by an indirect immunofluorescent test and the discrimination between Hantaan and Seoul viruses was done by RT-PCR-RFLP (reverse transcriptionpolymerase chain reaction-restriction fragment length polymorphism) against viral S segment.
Adult ; Diagnosis ; Diarrhea ; Discrimination (Psychology) ; Edema ; Female ; Fever ; Hantaan virus ; Hantavirus ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Korea ; Myalgia ; Seoul virus*

To know the difference in graft rejection after corneal transplantation between moist chamber and Optisol(Chiron Co. Irvine, CA, U.S.A.) as cornea preservation methods, we compared two groups involving 50 patients(71 eyes) who had undergone partially penetrating keratoplasty (PPKP) for the treatment of keratoconus or corneal dystrophy from 1991 to 1995. The graft rejection had occurred in 10 of 40 eyes(25%) in moist chamber group and 9 of 31 eyes(29%) in Optisol group, and the cases of permanent corneal opacity after rejection were 5 of 40 eyes(12.5%), 3 of 31 eyes(9.7%) respectively. No difference in the two groups was statistically significant(P<0.05). We found the fact that the difference did not exist in the results from graft rejection after PPKP using moist chamber method for short preservation period, or Optisol method for the relatively long period allowing serological and immunological screen test.
Cornea ; Corneal Opacity ; Corneal Transplantation ; Graft Rejection* ; Keratoconus ; Keratoplasty, Penetrating ; Transplants*

Mycobacterium lentiflavum has recently been described as an emerging human pathogen without regard to the immune status of the host. We herein report on M. lentiflavum isolated from a respiratory specimen of a patient. Although the organism described in this case seems to be a colonizer of a lung destroyed by tuberculosis, the current methods for species identification of nontuberculous mycobacteria have to be re-evaluated so as not to underestimate these organisms.
Aged ; Humans ; Male ; Mycobacterium/genetics/*isolation & purification ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary/diagnosis/*microbiology/radiography

The radial artery is generally the preferred access route in coronary angiography and coronary intervention. However, small size, spasm, and anatomical variations concerning the radial artery are major limitations of transradial coronary intervention (TRI). We describe a successful case involving a patient with coronary artery disease who underwent TRI via a well-developed radial recurrent artery branch from the radioulnar alpha loop using a sheathless guiding catheter.
Arteries ; Catheters ; Coronary Angiography ; Coronary Artery Disease ; Humans ; Percutaneous Coronary Intervention ; Radial Artery ; Spasm

The radial artery is generally the preferred access route in coronary angiography and coronary intervention. However, small size, spasm, and anatomical variations concerning the radial artery are major limitations of transradial coronary intervention (TRI). We describe a successful case involving a patient with coronary artery disease who underwent TRI via a well-developed radial recurrent artery branch from the radioulnar alpha loop using a sheathless guiding catheter.

No abstract available.
Hematoma ; Mesenteric Artery, Superior

We report a suspicious case of spontaneous bacterial peritonitis (SBP) caused by Providencia rettgeri and Clostridium perfringens in a patient with alcoholic cirrhosis. The patient presented with altered mentality and was taken to the emergency room. He was diagnosed with SBP after abdominal paracentesis and computed tomography and was treated with ceftriaxone and metronidazole. The pathogens were identified under suspicion of polymicrobial infection because of Gram-staining discrepancies between broth from blood culture bottles and colonies on solid media. He died of septic shock despite transfer to the intensive care unit. Although we could not conclude which organism had the leading role in this case of SBP and septicemia, we did verify the importance of Gram staining in a microbiology laboratory in terms of quality assurance.
Ceftriaxone ; Clostridium perfringens* ; Coinfection ; Emergency Service, Hospital ; Humans ; Intensive Care Units ; Liver Cirrhosis, Alcoholic ; Metronidazole ; Paracentesis ; Peritonitis* ; Providencia* ; Sepsis* ; Shock, Septic

BACKGROUND: Diagnosis of nontuberculous mycobacterium (NTM) is challenging, and clinical, radiological and microbiological criteria should be met. Traditionally, culture results on solid media have been reported semi-quantitatively, but no study exists regarding the clinical significance of low-colony count culture reports. The authors of the present study analyzed the clinical significance of low-colony count specimens of NTM with a greater than three-year follow-up period. METHODS: A total of 341 clinical isolates were evaluated among the isolates at Seoul National University Hospital and Seoul National University Borame Hospital from October 2005 to September 2006. Colony count less than 50 was considered a low-colony count specimen. Identifications of NTM from all the isolates were performed using a DNA chip (PCR reverse hybridization, LG Life Science, Korea). Clinical significance was analyzed by reviewing the medical records of patients with greater than three years of follow-up data after NTM isolation from respiratory samples. RESULTS: NTM lung disease was observed in 27.0% of the patients with low-colony count specimens among 167 patients with respiratory samples, and 70.4% of the patients were treated. The low-colony count patients had less NTM lung disease, longer incubation period, and less acid fast bacilli-positivity than patients with a colony count greater than 50. CONCLUSION: The prevalence of NTM lung disease with a low-colony count specimen was greater than 25%. In a clinical setting, NTM lung disease should not be excluded only on the basis of a low-colony count.
Biological Science Disciplines ; Chimera ; Follow-Up Studies ; Humans ; Lung Diseases ; Medical Records ; Nontuberculous Mycobacteria ; Oligonucleotide Array Sequence Analysis ; Prevalence