Robinsoniella peoriensis has recently been identified as a Gram-positive, spore-forming, anaerobic rod originally recovered from swine manure storage pits. To date, 6 cases of R. peoriensis infection have been reported, including 2 cases of bacteremia, 1 of abdominal fluid collection, and 3 of wound infection. In the present study, we report a 76-yr-old man with R. peoriensis bacteremia who developed aspiration pneumonia. Gram staining of a purified colony revealed Gram-positive, rod-shaped bacteria. Biochemical identification using API 20 A (bioMerieux, France) indicated presence of Clostridium spp. We performed both 500-bp and full-gene sequencing of 16S rRNA of the isolate. The sequence was analyzed with MicroSeq ID 16S rRNA Library v2.0 (Applied Biosystems, USA), GenBank Basic Local Alignment Search Tool (BLAST) (http://www.ncbi.nlm.nih.gov/genbank), and EzTaxon database v2.1 (http://www.eztaxon.org). The 500-bp 16S rRNA sequence of the blood culture isolate showed 99.16-99.79% similarity with R. peoriensis and the full-gene 16S rRNA sequence showed 98.87-99.50% similarity with R. peoriensis. The organism was confirmed as R. peoriensis by using all of the mentioned databases except for MicroSeq, which did not include the RNA sequence of this bacterium. This case suggests that identification of R. peoriensis might be challenging in clinical laboratories with no access to molecular methods, as certain commercial identification systems may not identify, or may misidentify, this organism. To the best of our knowledge, this is the first report of the isolation of R. peoriensis in Korea.
Aged ; Bacteremia/*microbiology ; Clostridium/classification/genetics/*isolation & purification ; Databases, Genetic ; Humans ; Male ; Phylogeny ; Pneumonia, Aspiration/*diagnosis/microbiology ; RNA, Ribosomal, 16S/chemistry/genetics ; Republic of Korea ; Sequence Analysis, DNA

Myofibroblastoma is a rare benign mesenchymal tumor of the breast. It presents as a well circumscribed, solitary nodular mass, and it has been reported to mainly occur in male patients. To our knowledge, few reports have described the radiologic appearance of myofibroblastoma in the female breast and there has been no report from Korea. We describe the mammographic, sonographic and histologic findings of a case of myofibroblastoma that presented as a well defined mass mimicking fibroadenoma in a 44-year-old woman.
Adult ; Breast* ; Female* ; Fibroadenoma ; Humans ; Korea ; Male ; Neoplasms, Muscle Tissue* ; Ultrasonography

γδ T cells are a rare and unique prototype of T cells that share properties with natural killer cells in secondary lymphoid organs. Although many studies have revealed the function and importance of adult-derived γδ T cells in cancer biology and regenerative medicine, the low numbers of these cells hamper their application as therapeutic cell sources in the clinic. To solve this problem, pluripotent stem cell-derived γδ T cells are considered alternative cell sources; however, few studies have reported the generation of human pluripotent stem cell-derived γδ T cells. In the present study, we investigated whether lymphoid lineage γδ T cells were successfully generated from human pluripotent stem cells via hemogenic endothelium under defined culture conditions. Our results revealed that pluripotent stem cells successfully generated γδ T cells with an overall increase in transcriptional activity of lymphoid lineage genes and cytolytic factors, indicating the importance of the optimization of culture conditions in generating lymphoid lineage γδ T cells. We uncovered an initial step in differentiating γδ T cells that could be applied to basic and translational investigations in the field of cancer biology. Based on our result, we will develop an appropriate method to purify γδ T cells with functionality and it helpful for the study of basic mechanism of γδ T cells in pathophysiologic condition as well as clinic application.

The diffuse form of supravalvar aortic stenosis represents a surgical challenge when the ascending aorta, aortic arch, proximal descending thoracic aorta and arch arteries are involved. It can be treated by a variety of surgical approaches. We report a case of severe diffuse supravalvar aortic stenosis combined with an aortic valve anomaly and occlusion of the right coronary artery ostium in a 14-year-old boy with Williams syndrome. We enlarged the aortic root (Nick's procedure), ascending aorta, aortic arch, proximal descending thoracic aorta, and innominate artery with patches and replaced aortic valve with 19 mm St. Jude valve. Deep hypothermic circulatory arrest and retrograde cerebral perfusion were used during repair of the arch and arch artery.
Adolescent ; Aorta ; Aorta, Thoracic ; Aortic Stenosis, Supravalvular* ; Aortic Valve* ; Arteries ; Brachiocephalic Trunk ; Circulatory Arrest, Deep Hypothermia Induced ; Coronary Vessels ; Humans ; Male ; Perfusion ; Williams Syndrome

The objective of this study was to analyze the influence of socio-demographic factors on food consumption frequencies among adolescents in Korea. Data were obtained from the Seventh Korea Youth Risk Behavior Web-based Survey (2011 KYRBS), a nationwide representative sample of 75,643 (37,873 males and 37,770 females) middle and high school students. It was carried out as a self-administered on-line survey. The frequency of eating breakfast was 4.8 times per week for middle school students and 4.6 times per week for high school students (p < 0.001). Higher levels of perceived household economic status, family affluence scale (FAS) and education attainment of mother were associated with more frequent breakfast eating. The frequencies of consumption of vegetables and milk were higher in males than in females (p < 0.001). The frequency of consumption fruits was higher in females than in males (p < 0.01). Higher levels of perceived household economic status, FAS and education attainment of mother were associated with more frequent consumption of vegetable, fruits and milk. The frequencies of consumption of soda, fast food and instant noodls were higher in males than in females (p < 0.001). The frequency of consumption of snacks was higher in females than in males. Adolescents with lower levels of FAS and education attainment of mother were at risk for skipping breakfast and consuming of soda, fast food and instant noodls more frequently. Whereas, adolescents with higher levels of FAS, education attainment of mother were more likely to be frequent consumers of vegetable, fruits and milk. These findings demonstrated that being high school students and belonging to lower level of socio-economic status (SES) were associated with undesirable food habits.
Adolescent ; Breakfast ; Eating ; Family Characteristics ; Fast Foods ; Female ; Food Habits ; Fruit ; Humans ; Korea ; Male ; Milk ; Mothers ; Risk-Taking ; Snacks ; Vegetables

PURPOSE: To describe and characterize the CT findings of the sternal masses. MATERIALS AND METHODS: We retrospectively reviewed the medical records, pathologic reports, and CT findings of 16 patients whose chest CT revealed sternal masses. Two primary tumors were found, namely chondrosar-comas. Twelve metastatic tumors had arisen were from lung cancer (n=4), breast cancer (n=3), hepatoma (n=2), osteosarcoma (n=1), carotid body paraganglioma (n=1), and immature sacrococcygeal teratoma (n=1). Others were Castleman's disease (n=1) and inflammatory pseudotumor (n=1). RESULTS: Chondrosarcomas were large expansile osteolytic masses showing a variable degree of cortical break-through and containing punctate chondroid calcifications. Most sternal metastases (83 %) were located in the manubrium and were accompanied by metastasis in other bones (83 %). Metastatic tumors were nonspecific osteolytic soft tissue masses showing homogeneous or inhomogeneous enhancement, except for those which arose from an osteosarcoma and a lung cancer, and showed osteoblastic lesions. Castleman's disease was seen as an ill-defined enhanced soft tissue mass involving the sternum and adjacent soft tissue. Inflammatory pseudotumor appeared as an infiltrating lesion around the sternoclavicular joint and was accompanied by sclerosis and the erosion of opposing sternal and clavicular ends. CONCLUSION: Most of the sternal masses are due to malignant neoplasms, among which metastatic tumors are more common than primary ones. Metastatic tumors affect the manubrium more commonly than the body portion, and most also affect other bones in the thorax. CT findings of metastatic tumors are non-specific and thus do not suggest their origin. Non-neoplastic masses are not readily differentiated from malignant tumors on the basis of CT findings alone and require pathological confirmation.
Breast Neoplasms ; Carcinoma, Hepatocellular ; Carotid Body Tumor ; Chondrosarcoma ; Giant Lymph Node Hyperplasia ; Granuloma, Plasma Cell ; Humans ; Lung Neoplasms ; Manubrium ; Medical Records ; Neoplasm Metastasis ; Osteoblasts ; Osteosarcoma ; Retrospective Studies ; Sclerosis ; Sternoclavicular Joint ; Sternum ; Teratoma ; Thorax ; Tomography, X-Ray Computed

Gestational trophoblastic disease (GTD) is a condition of uncertain etiology, choriocarcioma, or placental-site hydatidiform moles, invasive moles, choriocarcinoma, and placental-site trophoblastic tumors. It arises from the abnormal proliferation of trophoblastic tissue and spreads beyond the uterus hematogenously. The early diagnosis of GTD is important to ensure timely and successful management and the preservation of fertility. We report the unusual case of a metastatic choriocarcinoma that formed bullae on the lung surface and presented as recurrent pneumothorax in a 38-year-old woman with elevated beta-human chorionic gonadotropin (hCG) levels. She underwent thoracoscopic wedge resection of the involved lung and four subsequent cycles of consolidation chemotherapy. No other evidence of metastatic disease or recurrent pneumothorax was noted during 22 months of follow-up. GTD should be considered in the differential diagnosis of spontaneous pneumothorax in reproductive-age women with an antecedent pregnancy and abnormal beta-hCG levels.
Adult ; Choriocarcinoma* ; Chorionic Gonadotropin ; Consolidation Chemotherapy ; Diagnosis, Differential ; Drug Therapy ; Early Diagnosis ; Female ; Fertility ; Follow-Up Studies ; Gestational Trophoblastic Disease ; Humans ; Hydatidiform Mole, Invasive ; Lung ; Neoplasm Metastasis* ; Pneumothorax* ; Pregnancy ; Trophoblastic Tumor, Placental Site ; Trophoblasts ; Uterus

BACKGROUND: Stenosis of the left pulmonary artery (LPA) after repair of tetralogy of Fallot (TOF) is troublesome. A new technique of LPA angioplasty using an autologous MPA flap was performed in patients with TOF. MATERIALAND METHOD: From October 1998 to January 2001, 24 patients (median age; 10 months, range; 4 to 145 months)underwent total correction of TOF with LPA angioplasty using the autologous MPA flap. Five patients underwent pulmonary angioplasty without any patch over the MPA and LPA. The patches were required to enlarge only the MPA in 4 patients, and transannular RVOT widening was performed in 15. RESULT: There were no operative or late deaths. During follow-up (range: 6~42 months), reoperation for LPA stenosis was not required in any patients, but balloon angioplasty for branch pulmonary artery stenosis was performed in 3 patients. Echocardiography and CT angiography at the recent follow-up showed an obtuse angle between the MPA and LPA. CONCLUSION: Although further follow-up is needed, the angioplasty using the autologous MPA flap can be easily performed, avoiding patch-related complications, and allowing growth of the MPA flap. This angioplasty technique creates a more natural and obtuse angle between the MPA and LPA, which can minimize kinking of the LPA, especially in the patients who underwent transannular patch widening.
Angiography ; Angioplasty* ; Angioplasty, Balloon ; Constriction, Pathologic ; Echocardiography ; Follow-Up Studies ; Humans ; Pulmonary Artery* ; Reoperation ; Tetralogy of Fallot

BACKGROUND AND PURPOSE: The aim of this study was to determine the changes in diffusion-tensor images associated with medication-related impulse control disorder (ICD) in Parkinson's disease (PD) patients undergoing chronic dopamine-replacement therapy. METHODS: Nineteen PD patients, comprising 10 with ICD (PD-ICD) and 9 without ICD (PD-nonICD), and 18 age-matched healthy controls (HCs) with no cognitive or other psychiatric disorders were analyzed. All subjects underwent 3-T magnetic resonance diffusion-tensor imaging. For all PD patients, clinical data on PD duration, antiparkinsonian medication dosages, Unified Parkinson's Disease Rating Scale and Mini-Mental State Examination were collected. Whole-brain voxel-based measures of fractional anisotropy (FA) and mean diffusivity (MD) were analyzed. RESULTS: In comparison with HCs, the PD-nonICD subjects had low FA at the bilateral orbitofrontal areas. While the PD-ICD subjects exhibited no such difference, their FA was significantly elevated at the anterior corpus callosum. Analysis of FA between the two PD groups revealed that FA in the anterior corpus callosum, right internal capsule posterior limbs, right posterior cingulum, and right thalamic radiations were significantly higher (corrected p<0.05) in the PD-ICD than in the PD-nonICD patients. MD did not differ between the PD-ICD and PD-nonICD groups in any brain regions. CONCLUSIONS: The PD-ICD patients appear to have relatively preserved white-matter integrity in the regions involved in reward-related behaviors compared to PD-nonICD patients. Further investigation is required to determine whether the difference in FA between PD-ICD and PD-nonICD patients reflects microstructural differences in the pathological progression of PD or is secondary to ICD.
Anisotropy ; Brain ; Corpus Callosum ; Extremities ; Humans ; Disruptive, Impulse Control, and Conduct Disorders* ; Internal Capsule ; Parkinson Disease

OBJECTIVE: With the burgeoning elderly population, mental health among the elderly has surfaced as an important medical, social, and economic issue. This study was a pilot study testing the assessment module that was developed to survey mental health among the elderly living in the city of Busan. METHODS: Basic demographic data and mental health problems were investigated using the General Health Questionnaire-12 (GHQ-12), suicide risk screening tool, subjective memory deterioration scale, sleep disorder and sleep pattern scale, health-related quality of life scale (EuroQoL-5 dimension), and alcohol abuse screening tool (Cut down, Annoyed, Guilty, Eye-opener Questionnaire). RESULTS: Four-hundred adults aged 65 years or older living in either of two districts in the Busan metropolitan city participated in the study, of whom 219 (54.8%) were female. About 26.8% of the participants were obese, while 2.3% were underweight. One hundred and twenty-five (31.3%) participants were in need of attention to or improvement of nutrition management, and 19.1% perceived themselves to be in poor health. In the GHQ-12, 68.8% were in psychological distress (≥2). About 49.8% of the participants had insomnia, 61.8% had subjective memory disturbance, and 6% were at risk of suicide. The GHQ-12 score, proportion of participants with sleep disturbance, and subjective memory deterioration was significantly higher among women than in men, while health-related quality of life was higher in men. CONCLUSION: A considerable number of older adults living in the Busan region were suffering from psychological stress, were in need of nutrition management, had low quality of life, and had poor mental health, and women were particularly more vulnerable.
Adult ; Aged* ; Alcoholism ; Busan ; Female ; Humans ; Male ; Mass Screening ; Memory ; Mental Health* ; Pilot Projects* ; Quality of Life ; Sleep Initiation and Maintenance Disorders ; Sleep Wake Disorders ; Stress, Psychological ; Suicide ; Thinness