Ochrobactrum anthropi is a ubiquitous gram-negative bacillus and currently thought to be an opportunistic pathogen. We experienced a 66-year-old male patient with continuous ambulatory peritoneal dialysis (CAPD)-related peritonitis caused by O. anthropi. Susceptible antibiotic therapy including amikacin and ciprofloxacin improved the patient's clinical status. However, peritoneal effluent showed sustained leukocytosis, thus CAPD catheter was removed. After 2 weeks of temporary hemodialysis, CAPD was successfully restarted with reinsertion of catheter. This is, to our knowledge, the first case of CAPD-related peritonitis caused by O. anthropi in Korea.
Aged ; Amikacin ; Bacillus ; Catheters ; Ciprofloxacin ; Humans ; Korea ; Leukocytosis ; Male ; Ochrobactrum ; Ochrobactrum anthropi ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Renal Dialysis

Traditionally, open choledochotomy with T-tube choledochostomy had been considered as the "gold standard" for choledocholithiasis. Recently, the frequency of performing the open choledochotomy with T-tube choledohostomy has decreased due to the progression of several less invasive procedures and laparoscopic technques, but until now open choledochotomy with T-tube choledochostomy is the most popular procedure in choledocholithiasis. Therefore we reviewed 126 cases who were treated with open choledochotomy with T-tube choledochostomy from January 1987 to June 1996 at our institution in order to inspect the several problematic points especially after T-tube removal. The results are summarized as follows, 1) The sex ratio of male to female was 1:1.29, and the average age was 59.6 years old. 2) 119 cases (94.4%) were biliary tract stone disease and 7 cases (5.6%) were non-calculous benign biliary tract disease. The most common etiologic disease was GB and CBD stone (37.3%). 3) Most of postoperative T-tube cholangiography was performed within 14 days (84.1%). 4) The number of patients containing some residual stone at postoperative T-tube cholangiography was 29 cases (23%). 14 of these patients were treated by Dormia-basket stone removal and its success rate was 85.7%. 5) The T-tube was removed within 2 months in 109 cases (86.5%). 6) The number of complications after T-tube removal were 8 cases (6.3%). All of them had bile peritonitis symptomes, and three of them were treated by reoperation. 7) The postoperative complications were noted in 27 cases (21.4%). and the most frequent complication is wound infection (25.8%). The postoperative mortality was noted in 1 case (0.8%).
Bile ; Biliary Tract ; Biliary Tract Diseases ; Cholangiography ; Choledocholithiasis ; Choledochostomy* ; Female ; Humans ; Male ; Mortality ; Peritonitis ; Postoperative Complications ; Reoperation ; Sex Ratio ; Wound Infection

BACKGROUND: Cytomegalovirus(CMV) disease is an important opportunistic infection and contributes to significant morbidity and mortality in immunocompromised hosts. To determine predisposing conditions to CMV disease and its prognosis, the authors reviewed the clinical courses of patients with CMV disease. METHODS: We reviewed medical records of 23 patients with CMV disease diagnosed at Seoul National University Hospital from 1987 to 1997. RESULTS: CMV pneumonia was diagnosed in 8 patients. Underlying conditions of the patients were allogeneic bone marrow transplant(BMT) in 4 patients, lupus nephritis in 1, dermatomyositis in 1, and renal transplantation recipient in 1. The cumulative dose of corticosteroid given to the BMT recipients before the development of CMV pneumonia ranged between 1,000 and 4,700 mg, whereas that to the non-BMT patients ranged between 2,100 and 6,000 mg. Of the 8 patients with CMV pneumonia, five patients(75%) died. Of the 15 CMV gastroenteritis, two had CMV gastric ulcers. The gastric ulcers showed clinical and endoscopic improvement with systemic ganciclovir therapy. Among 13 patients with CMV enterocolitis, nine had preceding GI diseases, and nine had received systemic corticosteroids. Five patients died. The mortality was lower in patients with underlying bowel diseases than in those without ones(22% vs. 75%, respectively). CONCLUSION: The mortality of CMV disease was 62.5%, 0%, and 38% in patients with CMV pneumonia, gastric ulcer, and enterocolitis, respectively. GVHD, systemic corticosteroid and/or immunosuppressive therapy were major risk factors of CMV diseases.
Adrenal Cortex Hormones ; Bone Marrow ; Cytomegalovirus* ; Dermatomyositis ; Enterocolitis ; Ganciclovir ; Gastroenteritis ; Humans ; Immunocompromised Host ; Kidney Transplantation ; Lupus Nephritis ; Medical Records ; Mortality ; Opportunistic Infections ; Pneumonia ; Prognosis ; Risk Factors ; Seoul ; Stomach Ulcer

The profile of membrane currents was investigated in differentiated neuronal cells derived from human neural stem cells (hNSCs) that were obtained from aborted fetal cortex. Whole-cell voltage clamp recording revealed at least 4 different currents: a tetrodotoxin (TTX)-sensitive Na+ current, a hyperpolarization-activated inward current, and A-type and delayed rectifier-type K+ outward currents. Both types of K+ outward currents were blocked by either 5 mM tetraethylammonium (TEA) or 5 mM 4-aminopyridine (4-AP). The hyperpolarization-activated current resembled the classical K+ inward current in that it exhibited a voltage-dependent block in the presence of external Ba2+ (30micrometer) or Cs+ (3micrometer). However, the reversal potentials did not match well with the predicted K+ equilibrium potentials, suggesting that it was not a classical K+ inward rectifier current. The other Na+ inward current resembled the classical Na+ current observed in pharmacological studies. The expression of these channels may contribute to generation and repolarization of action potential and might be regarded as functional markers for hNSCs-derived neurons.
4-Aminopyridine ; Action Potentials ; Humans ; Membranes ; Neural Stem Cells ; Neurons ; Tetraethylammonium ; Tetrodotoxin

Background: Recent studies have successfully implemented next-generation sequencing (NGS) in HLA typing. We performed HLA NGS in a Korean population to estimate HLA-A, -B, -C, and -DRB1 allele and haplotype frequencies up to an 8-digit resolution, which might be useful for an extended application of HLA results. Methods: A total of 128 samples collected from healthy unrelated Korean adults, previously subjected to Sanger sequencing for 6-digit HLA analysis, were used. NGS was performed for HLA-A, -B, -C, and -DRB1 using the AllType NGS kit (One Lambda, West Hills, CA, USA), Ion Torrent S5 platform (Thermo Fisher Scientific, Waltham, MA, USA), and Type Steam Visual NGS analysis software (One Lambda). Results: Eight HLA alleles showed frequencies of ≥ 10% in the Korean population, namely, A*24:02:01:01 (19.5%), A*33:03:01 (15.6%), A*02:01:01:01 (14.5%), A*11:01:01:01 (13.3%), B*15:01:01:01 (10.2%), C*01:02:01 (19.9%), C*03:04:01:02 (11.3%), and DRB1*09:01:02 (10.2%). Nine previous 6-digit HLA alleles were further identified as two or more 8-digit HLA alleles. Of these, eight alleles (A*24:02:01, B*35:01:01, B*40:01:02, B*55:02:01, B*58:01:01, C*03:02:02, C*07:02:01, and DRB1*07:01:01) were identified as two 8-digit HLA alleles, and one allele (B*51:01:01) was identified as three 8-digit HLA alleles. The most frequent four-loci haplotype was HLA-A*33:03:01-B*44:03:01:01-C*14:03-DRB1*13:02:01. Conclusions We identified 8-digit HLA-A, -B, -C, and -DRB1 allele and haplotype frequencies in a healthy Korean population using NGS. These new data can be used as a representative Korean data for further disease-related HLA type analysis.

BACKGROUND/AIMS: Functional and anatomical abnormalities of mitochondria play an important role in developing steatohepatitis. Carnitine is essential for enhanced mitochondrial beta oxidation through the transfer of long-chain fatty acids into the mitochondria. We examined the impact of carnitine complex on liver function and peripheral blood mitochondria copy number in NAFLD patients. METHODS: Forty-five NAFLD patients were enrolled. Patients were categorized into the carnitine complex-administered group and control group. Before and 3 months after drug administration, a liver function test and peripheral blood mitochondrial DNA and 8-oxo-dG quantitive analysis were conducted. RESULTS: In carnitine treatment group, ALT, AST, and total bilirubin were reduced after medication. There was no difference in AST, ALT, and total bilirubin between before and after treatment in control group. In carnitine group, peripheral mitochondrial DNA copy number was significantly increased from 158.8+/-69.5 copy to 241.6+/-180.6 copy (p=0.025). While in control group the mitochondrial copy number was slightly reduced from 205.5+/-142.3 to 150.0+/-109.7. 8-oxo-dG level was also tended to decrease in carnitine group (p=0.23) and tended to increase in control group (p=0.07). CONCLUSIONS: In NAFLD, the carnitine improved liver profile and peripheral blood mitochondrial DNA copy number. This results suggest that carnitine activate the mitochondria, thereby contributing to the improvement of NAFLD.
Adult ; Aged ; Alanine Transaminase/blood ; Aspartate Aminotransferases/blood ; Bilirubin/blood ; Carnitine/*therapeutic use ; DNA Copy Number Variations/*drug effects ; DNA, Mitochondrial/*blood ; Deoxyguanosine/analogs &derivatives/analysis ; Fatty Liver/diagnosis/*drug therapy/genetics ; Female ; Humans ; Liver Function Tests ; Male ; Middle Aged

BACKGROUND/AIMS: Infliximab has been shown to be effective and safe for treating refractory luminal and fistulizing Crohn's disease (CD). The aim of this study was to report the efficacy and adverse effect of infliximab therapy in patients with CD at our center. METHODS: Medical records of thirteen patients who were treated with infliximab for refractory luminal or fistulizing CD were reviewed. Clinical response was classified as complete response, partial response and nonresponse. RESULTS: Seven patients were treated for fistulizing CD, four patients for luminal CD, and two for both. The mean time of follow-up was 13.1 months (3.3-28.1 months). Clinical response was seen in 10/13 (77%); complete response 7/13 (54%), partial response 3/13 (23%), nonresponse 3/13 (23%). Mean time to response was 27.1 days (10-41 days). 4 of 10 responders (40%) maintained remission over 30 weeks. Those who started on immunosuppressive treatment more than 3 months before infliximab infusion achieved lower early recurrence rate (14%) compared with those less than 3 months (67%) (p=0.039). Steroid tapering was successful in 7/12 (58%). Five patients required surgical therapy; three nonresponders, one partial responder and one who recurred after initial complete response. Initial responders required less surgery than nonresponders (p=0.035). Acute infusion reactions were seen in 2/40 infusions (5%). One patient developed herpes zoster 20 weeks after infliximab infusion. During follow-up peried, no patient developed serious infection, tuberculosis or malignancy. CONCLUSIONS: Infliximab is effective and safe in clinical practice. Concurrent immunosuppressive use is associated with lower rate of early recurrence.
Adult ; Antibodies, Monoclonal/adverse effects/*therapeutic use ; Crohn Disease/*drug therapy ; Female ; Gastrointestinal Agents/adverse effects/*therapeutic use ; Humans ; Immunosuppressive Agents/therapeutic use ; Male

Adenocarcinoma is the most common type of malignant tumor arising in the stomach, accounting for approximately 95% of malignant gastric neoplasms. The majority of remainder is lymphoma. Although H. pylori infection has been implicated as a common cause of both adenocarcinoma and lymphoma of the stomach, synchronous occurrence of both tumors is very rare. We present a case of a 23- year-old-female who presented with epigastric discomfort and was found to have synchronous low-grade B-cell MALT lymphoma and adenocarcinoma of the stomach in association with H. pylori infection.
Adenocarcinoma ; B-Lymphocytes ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Stomach ; Stomach Neoplasms*

BACKGROUND/AIMS: The role of Helicobacter pylori in bile reflux gastritis (BRG) is uncertain. We show the role of H. pylori and pathology in BRG. METHODS: Thirty seven patients, including 5 patients who had undergone subtotal gastrectomy, were diagnosed with BRG by gastroscopic findings of bile-stained mucosa with hyperemia/ erosions. We measured total bile acid (TBA) concentration and compared the H. pylori positivity between BRG patients and 70 non-BRG patients. We showed how often we could see the pathologic findings of reactive gastritis in BRG and compared the grade of lymphoplasma cell and neutrophil infiltration between H. pylori positive and negative group in BRG. RESULTS: TBA concentration of 10 patients was 7,376.7+/-5,482.6micro mol/L. H. pylori positive rate of BRG was 45.9% and that of non-BRG was 70% (p=0.015). The gastric pit elongation and tortuosity were found only in 3 cases with gastric surgery. The grade of lymphoplasma cell and neutrophil infiltration was 2.41+/-0.51 and 1.88+/-0.86 in H. pylori positive BRG and 1.55+/-0.69 and 0.55+/-0.76 in H. pylori negative BRG, respectively (p<0.001). CONCLUSIONS: H. pylori infection in BRG was lower than that in non-BRG. The gastric pit elongation and tortuosity of BRG were not seen often. The lymphoplasma cell and neutrophil infiltration were relatively sparse in H. pylori negative BRG.
Bile Reflux* ; Bile* ; Duodenogastric Reflux ; Gastrectomy ; Gastritis* ; Helicobacter pylori* ; Helicobacter* ; Humans ; Mucous Membrane ; Neutrophil Infiltration ; Pathology

Systemic lupus erythematosus is a disease of unknown cause which involves various organs and primary involvement of urinary bladder is very rare. We experienced a case of a female patient with SLE and urologic manifestations (interstitial cystitis, hydroureters and hydronephrosis), which were resolved spontaneously without any immunosuppressive therapy. There was no significant correlation between clinical course and disease activity index.
Cystitis* ; Female ; Humans ; Lupus Erythematosus, Systemic ; Remission, Spontaneous ; Urinary Bladder