No abstract available.

BACKGROUND: Rapid and accurate identification of methicillin-resistant Staphylococcus (MRSA) is very important for patients because they are one of the most common etiologic agents of hospital infection. Conventional identification methods for MRSA are influenced by various factors such as pH, concentration of salt, conditions of media. METHODS: 53 methicillin resistant staphylococcus strains identified by ATB plus system (Biomerieux, France) were preformed the polymerase chain reaction (PCR), Southern blot hybridization fort the detection of mec A gene, and subcultured in Meuller-Hinton media containing 4 microgram/mL oxacillin for the comparison. RESULTS: The correlation of detection rate of mec A gene PCR and ATB plus systems was 81.6%. The correlation of mec A gene PCR and MRSA on Mueller-Hinton media containing 4 microgram/mL oxacillin was 80%. We confirmed by Southern blot hybridization the amplified mer A gene originated from chromosome of MRSA. As the results of oxacillin sensitivity test, minimal inhibitory concentrations of MRSA were distributed between 40 microgram/mL and 320 microgram/mL. When compared with executing time, ATB plus system took 24 hours, but PCR took 5 hours for identification. CONCLUSION: We concluded that mec A gone PCR techniques were simple and rapid for detection of MRSA comparative to conventional methods.
Blotting, Southern ; Cross Infection ; Genes, vif ; Humans ; Hydrogen-Ion Concentration ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Oxacillin ; Polymerase Chain Reaction* ; Staphylococcus

No abstract available.
Pseudomonas aeruginosa*

PURPOSE: Henoch-Schonlein purpura(HSP) is a systemic vasculitis, characterized by cutaneous purpura, abdominal pain, arthralgia and renal involvement. The clinical features of HSP have been reasonably well documented but there are still many gaps in our understanding of HSP. The aim of this study was to present the clinical features of 125 children with HSP and compare them with previous reports, placing particular emphasis on clinical information. METHODS: We collected the clinical data of 125 patients with acute HSP who visited Chungbuk National University Hospital from March 1992 to April 2002. Data were expressed as the mean or mean +/-SD and statistical analysis was performed using Chi-square approximation. P<0.05 was considered as significant. RESULTS: The patient population consisted of 87 boys and 38 girls ranging in age from one to 14 years. HSP occurs throughout the year, but this study shows seasonal skewing, with most patients presenting from fall through spring and a paucity of cases in summer. All patients had non-throm bocytopenic purpura concentrated on the buttocks and lower extremities. Purpuric lesions were also scattered on the arms and occaisionally on the face and ears, but the trunk was largely spared. A recurrence of purpura was defined as the reappearance of a rash or other symptoms following resolution of disease for at least two weeks. The mean number of recurrences was 0.51. Eighty eight patients(70.4%), 18 patients(14.4%) and 67 patients(53.6%) complained of abdomianl pain, gastroin testinal bleeding and arthralgia, respectively. Nephritis occurred in 48(38.4%) patients. Fifteen boys (17.2%) developed epididymitis. Neurologic features occurred in 13(10.4%) and two(15%) of these were seizures. CONCLUSION: HSP all showing purpura as defined is characterized by various clinical features, including abdominal pain, arthralgia, epididymitis and nephritis which could occur before the appearance of purpura. Therefore, we suggest that the possibility of HSP should be considered in children before invasive procedures, even if the above symptoms and signs present without purpura.
Abdominal Pain ; Arm ; Arthralgia ; Buttocks ; Child ; Chungcheongbuk-do ; Ear ; Epididymitis ; Exanthema ; Female ; Hemorrhage ; Humans ; Lower Extremity ; Male ; Nephritis ; Prognosis ; Purpura ; Purpura, Schoenlein-Henoch* ; Recurrence ; Seasons ; Seizures ; Systemic Vasculitis

BACKGROUND: Hepcidin plays a central role in the regulation of iron metabolism, and hepatic iron production is stimulated by iron load and inflammation. Recent animal studies have shown that hepcidin levels increase when hematopoiesis is blocked. We aimed to monitor pre- and post-stem cell transplantation hepcidin levels and evaluate its association with hematologic recovery. METHODS: The study group comprised 12 patients with hematologic malignancies (7 with AML, 4 with ALL, and 1 with refractory anemia with excess blasts-2) undergoing allogeneic peripheral blood stem cell transplantation (PBSCT). One day before and 3 days, 1 week, 2 weeks, 4 weeks, and 8 weeks after PBSCT, reticulocyte count and levels of Hb, ferritin, and C-reactive protein were monitored; serum hepcidin-25 was measured by ELISA. RESULTS: The median serum hepcidin-25 levels (ng/mL) were significantly higher until 1 week after PBSCT (103.6, 103.3, and 96.5) than those at 2, 4, and 8 weeks after PBSCT (63.9, 53.9, and 56.6, respectively). The reticulocyte count also significantly increased from 2 weeks after PBSCT. The hepcidin level showed an inverse correlation with reticulocyte count (r=-0.56, P<0.001) and a weak positive correlation with ferritin (r=0.27, P=0.02). At 2 weeks, patients with high hepcidin levels (> or =63.9) tended to demonstrate lower Hb recovery at 8 weeks than patients with low hepcidin levels did (P=0.15), but without any differences in the incidence of complications. CONCLUSIONS: These findings indicate that hepcidin production is associated with erythropoietic activity and that hepcidin level may be used as an early marker of hematopoietic recovery in PBSCT.
Anemia, Refractory ; Animals ; Antimicrobial Cationic Peptides ; C-Reactive Protein ; Cell Transplantation ; Ferritins ; Hematologic Neoplasms ; Hematopoiesis ; Humans ; Incidence ; Inflammation ; Iron ; Organothiophosphorus Compounds ; Peripheral Blood Stem Cell Transplantation ; Reticulocyte Count ; Stem Cell Transplantation ; Transplants

Methylmalonic acidemia (MMA) is a heterogeneous inborn error of propionate metabolism and its management frequently includes a low-protein diet to minimize precursors of methylmalonic acid and reduce its concentration in body tissues. In the long- term follow-up, renal dysfunction in these patients has been increasingly recognized. Tubulointerstitial nephritis is the most frequent renal complications and has been reported in the small number of renal biopsy specimens from young children previously by others. We report a case of a 18-year-old girl with MMA and renal dysfunction in whom renal biopsy demonstrated chronic tubulointerstitial nephritis.
Adolescent ; Biopsy ; Child ; Diet, Protein-Restricted ; Diethylpropion ; Female ; Follow-Up Studies ; Humans ; Metabolism ; Methylmalonic Acid ; Nephritis, Interstitial*

PURPOSE: Henoch-Schonlein purpura (HSP) is a multisystem disorder affecting predominantly skin, gastrointestinal tract, joint and kidneys, as well as the central nervous, cardiopulmonary and musculoskeletal system. Most patients with renal involvement have a good prognosis. However, some patients develop end-stage renal disease. Therefore, severity of renal involvement is considered to contribute to the outcome. The aim of this study was to evaluate the clinical renal risk and prognostic factors of HSP. METHODS: We had collected the clinical and laboratory data of 125 patients with acute HSP who visited Chungbuk National University Hospital from March 1992 to April 2002. Data were expressed as the mean+/-SD and statistical analysis was performed using Wilcoxon rank sum test, Mantel-Haenszel test, Fisher's Exact test, Student t-test. p<0.05 was considered as significant. RESULTS: The patient population consisted of 87 boys and 38 girls ranging from 1 to 14 years in age. Recurrance number of purpura in the HSP patients with renal involvement were significantly higher than those without renal involvement (p<0.01). 24-hour urine protein/creatinine ratio in the HSP patients with renal involvement were significantly higher than those without renal involvement (p< 0.01). But serum C3, C4, CH50, anti-streptolysin titers and so forth had no correlation with renal involvement. In the HSN patients, 24-hour creatinine and creatinine clearance have no correlation with renal involvement. Fifteen of 87 boys (17.2%) in this study developed scrotal involvement, which showed no significantly difference in patients with or without renal involvement. CONCLUSION: It is important that 24-hour urine protein/creatinine ratio at acute stage shows a significant relation with renal involvement. Results suggest that recurrence number of purpura are important to renal involvement in HSP. Based on these findings, futher prospective and/or controlled studies among more patients are thus necessary in order to prevent renal involvement in HSP.
Chungcheongbuk-do ; Creatinine ; Female ; Gastrointestinal Tract ; Humans ; Joints ; Kidney ; Kidney Failure, Chronic ; Musculoskeletal System ; Prognosis ; Purpura ; Purpura, Schoenlein-Henoch* ; Recurrence ; Risk Factors* ; Skin ; Systemic Vasculitis

BACKGROUND: It had been well known that breast feeding to infants has many advantages and benefits comparing to formula feeding. So, We performed this study to clarify the relationship between immunoglobulin (Ig) levels and diet during newborn period. METHODS: We measured the levels of IgG, IgA and IgM by Array 360 System (Beckman Instruments, CA, U.S.A). Subjects were 29 breast-fed and 13 formula-fed newborns. We evaluated the results and analyzed the change of concentrations of IgG, IgA and IgM according to diet, sex and postnatal period. RESULTS: The levels of IgG, IgA and IgM in breast-fed newborns at postnatal 1-day were higher than formula-fed newborns, but the levels of Ig G and Ig A in formula-fed newborns at postnatal 30-day were higher than breast-fed newborns. CONCLUSIONS: There was no clinical signficance in the difference of IgG, IgA and IgM levels according to diet, sex and postnatal period, respectively.
Breast Feeding ; Diet ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins* ; Infant ; Infant, Newborn*

PURPOSE: Angiotensin II plays a potent role in renal injury not only by vasoconstrictive effects but also by biochemical effects. We investigated the effect of angiotensin II on ZO-1 (zonular occludens-1), a component of the slit diaphragm domain connecting slit diaphragm structure and actin cytoskeleton, in the glomerular epithelial cells (podocytes) for the glomerular damage. We tried to find that this effect could be prevented by losartan, an angiotensin II type 1 receptor blocker. METHODS: Glomerular epithelial cells were treated with various concentrations of angiotensin II and losartan. The distribution of ZO-1 was observed by confocal microscope and the change of ZO-1 expression was measured by Western blotting and RT-PCR. RESULTS: The intensities of fluorescences and bands of ZO-1 protein were decreased by angiotensin II in a dose-dependent manner by confocal microscopy and Western blot analysis, respectively. ZO-1 also moved from peripheral to inner cytoplasm and lost its linear pattern. These distributional changes of ZO-1 protein by angiotensin II were reversed by losartan in a dose-dependent manner. Angiotensin II reduced the amount and mRNA expresssion of ZO-1 which were also reversed by losartan. CONCLUSION: Angiotensin II decreases the amount of ZO-1 protein and changes its localization through angiotensin II type 1 receptor. These findings suggest that angiotensin II-added condition induces the cytoplasmic translocation and suppresses the production of ZO-1 in podocytes at transcriptional level, and could be prevented by angiotensin receptor antagonists.
Actin Cytoskeleton ; Adherens Junctions ; Angiotensin II Type 1 Receptor Blockers ; Angiotensin II* ; Angiotensin Receptor Antagonists ; Angiotensins* ; Blotting, Western ; Cytoplasm ; Diaphragm ; Epithelial Cells* ; Losartan ; Microscopy, Confocal ; Podocytes ; Receptor, Angiotensin, Type 1 ; RNA, Messenger

BACKGROUND: Multidrug-resistant (MDR) Acinetobacter spp. acquire antimicrobial agent-resistance genes via class 1 integrons. In this study, integrons were characterized to investigate the antimicrobial resistance mechanisms of MDR Acinetobacter isolates. In addition, the relationship between the integron type and integron-harboring bacterial species was analyzed by using epidemiological typing methods. METHODS: Fifty-six MDR Acinetobacter spp.-A. baumannii (N=30), A. bereziniae (N=4), A. nosocomialis (N=5), and A. pittii (N=17)-were isolated. The minimum inhibitory concentrations (MICs) were determined on the basis of the results of the Epsilometer test (Etest). PCR and DNA sequencing was performed to characterize the gene cassette arrays of class 1 integrons. Multilocus sequence typing (MLST) and repetitive extragenic palindromic sequence (REP)-PCR were performed for epidemiological typing. RESULTS: Class 1 integrons were detected in 50 (89.3%) of the 56 isolates, but no class 2 or 3 integron was found within the cohorts. The class 1 integrons were classified into 4 types: 2.3-kb type A (aacA4-catB8-aadA1), 3.0-kb type B (aacA4-blaI(MP-1)-bla(OXA-2)), 3.0-kb type C (bla(VIM-2)-aacA7-aadA1), and 1.8-kb type D (aac3-1-bla(OXA-2)-orfD). Type A was most prevalent and was detected only in A. baumannii isolates, except for one A. bereziniae isolate; however, type B was amplified in all Acinetobacter isolates except for A. baumannii isolates, regardless of clone and separation time of the bacteria. CONCLUSIONS: Although class 1 integron can be transferred horizontally between unrelated isolates belonging to different species, certain types of class 1 integrons tend to transfer horizontally and vertically among A. baumannii or non-baumannii Acinetobacter isolates.
Acinetobacter/drug effects/isolation & purification/*metabolism ; Acinetobacter Infections/epidemiology/microbiology ; Acinetobacter baumannii/drug effects/isolation & purification/metabolism ; Anti-Bacterial Agents/pharmacology ; DNA, Bacterial/chemistry/metabolism ; Drug Resistance, Multiple, Bacterial ; Humans ; Integrons/*genetics ; Microbial Sensitivity Tests ; Multilocus Sequence Typing ; Polymerase Chain Reaction ; Republic of Korea