PURPOSE:Enhanced immunosuppression for preventing acute rejection, But infection is an inevitable complication. This study was performed to evaluate the risk factors of herpes simplex virus (HSV) and varicella zoster virus (VZV) infection which are frequent and serious complication of renal transplant recipients. METHOD:We evaluated the incidence and risk factors for post-transplant HSV and VZV infection in three hundred and twenty three adult renal transplant recipients. RESULTS:The averaged period of infection was 37.8 months and 42% of infection occurred within six month after transplantation. Prevalence of HSV and VZV infection in diabetes patients are higher than that of non-diabetes patients (p=0.01). The other factors such as age, sex, acute rejection and immunosuppressive regimens, antibody induction didnt affect HSV and VZV infections in renal transplant recipients. CONCLUSION:As diabetic condition suggested more susceptibility to HSV and VZV infections, it is necessary to evaluate the possible occurrence of HSV and VZV infections carefully in transplant recipients with diabetes.
Adult ; Chickenpox ; Herpes Simplex ; Herpesvirus 3, Human ; Humans ; Immunosuppression ; Incidence ; Kidney ; Kidney Transplantation ; Methylmethacrylates ; Polystyrenes ; Prevalence ; Rejection (Psychology) ; Risk Factors ; Simplexvirus ; Transplants

PURPOSE: This study was aimed at finding clinical factors to be associated with a progressive course of IgA nephropathy. METHODS: We investigated the association between the prognosis of IgA nephropathy and clinical and laboratory findings including age, sex, hypertension, diabetes mellitus, 24-hour urine protein, macroscopic hematuria, hematuria duration, serum uric acid, serum creatinine, GFR, upper respiratory infection, pathological observation, and treatment protocols. One hundred seventy seven patients were followed up for more than 2 years at Kyung Hee university medical center from January 1997 through December 2006. Kidney size and echogenicity were measured by abdominal ultrasonography. Resistive index was calculated by doppler ultrasonography. RESULTS: Long hematuria duration, increased uric acid, elevated creatinine of chronic renal failure group were distinguished from those of normal and acute renal failure group statistically. Using multivariate analysis, three factors, elevated serum uric acid, decreased GFR, ACE inhibitor or ARB and steroid combination treatment proved to be independent prognostic indicators of acute renal failure of IgA nephropathy. Heavy proteinuria, long hematuria duration, and severe histopathologic findings by Haas' classification were associated with significant risk factors for developing chronic renal failure. CONCLUSION: At diagnosis of IgA nephropathy, hematuria continuation and histological damage in Haas' classification were related with the reduction of renal function.
Academic Medical Centers ; Acute Kidney Injury ; Clinical Protocols ; Creatinine ; Diabetes Mellitus ; Glomerulonephritis, IGA ; Hematuria ; Humans ; Hypertension ; Immunoglobulin A ; Kidney ; Kidney Failure, Chronic ; Multivariate Analysis ; Prognosis ; Proteinuria ; Risk Factors ; Ultrasonography, Doppler ; Uric Acid

BACKGROUND: We investigated the effects of the common polymorphisms in the peroxisome proliferator- activated receptor gamma2 (PPAR-gamma2 Pro12Ala) and in PPAR-gamma coactivator 1alpha (PGC-1alpha Gly482Ser) genes on the association with the nephropathy of Korean patients with type 2 diabetes mellitus. METHODS: A total of 113 patients with type 2 diabetes and 123 patients with diabetic nephropathy were enrolled in this study. The Pro12Ala polymorphism of the PPAR-gamma2 gene and the Gly482Ser polymorphism in the PGC-1alpha gene were determined with the polymerase chain reaction amplification, BstU-I and Msp I enzyme digestion, and gel electrophoresis. RESULTS: The genotype and allelic frequency of PPAR-gamma2 Pro12Ala gene were not different statistically between the diabetic nephropathy and the control. The genotype of PGC-1alpha Gly482Ser in diabetic nephropathy was also not different from those in control. The allelic frequency and carriage rate of Ser allele in PGC-1alpha Gly482Ser were significantly higher in patients with diabetic nephropathy than those in control (respectively, p<0.05). CONCLUSION: The polymorphisms of the PGC-1alpha Gly482Ser gene are significantly associated with the nephropathy in Korean patients with type 2 diabetes mellitus.

BACKGROUND: We investigated the effects of the common polymorphisms in the peroxisome proliferator- activated receptor gamma2 (PPAR-gamma2 Pro12Ala) and in PPAR-gamma coactivator 1alpha (PGC-1alpha Gly482Ser) genes on the association with the nephropathy of Korean patients with type 2 diabetes mellitus. METHODS: A total of 113 patients with type 2 diabetes and 123 patients with diabetic nephropathy were enrolled in this study. The Pro12Ala polymorphism of the PPAR-gamma2 gene and the Gly482Ser polymorphism in the PGC-1alpha gene were determined with the polymerase chain reaction amplification, BstU-I and Msp I enzyme digestion, and gel electrophoresis. RESULTS: The genotype and allelic frequency of PPAR-gamma2 Pro12Ala gene were not different statistically between the diabetic nephropathy and the control. The genotype of PGC-1alpha Gly482Ser in diabetic nephropathy was also not different from those in control. The allelic frequency and carriage rate of Ser allele in PGC-1alpha Gly482Ser were significantly higher in patients with diabetic nephropathy than those in control (respectively, p<0.05). CONCLUSION: The polymorphisms of the PGC-1alpha Gly482Ser gene are significantly associated with the nephropathy in Korean patients with type 2 diabetes mellitus.

PURPOSE: In IgA nephropathy (IgAN), crescent formation appears to represent a nonspecific response to severe injury to the glomerular capillary wall. This study was performed to evaluate the clinicopathological manifestations of the crescents and their effects on the clinical courses of IgAN. METHODS: The patients diagnosed IgAN were included and the information about their renal biopsies, chemistries and immunohistochemistry findings were collected retrospectively. Some patients that have similar renal function and protenuria were followed up for 12 months to examine the effects of crescents on the renal prognosis. RESULTS: 38 patients with crescents and 177 patients without crescents were enrolled. The patients with IgAN with crescents showed significantly lower renal function (MDRD eGFR 58.5 vs 88.4 ml/min/1.73m2), higher blood pressure, larger amount of proteinuria and more severe hematuria than those patients without crescents. In pathologic findings, HS Lee grades were higher (2.9 vs 1.9). When we selected patients with mildly decreased renal function (serum creatinine <2.5 mg/dL, PCR 0.5-8 g/gCr), the patients with crescents presented lower renal function and higher proteinuria but no statistical significance. After 12 months of treatment, the patients with crescents showed significantly lower renal function (MDRD eGFR 78.6 vs 96.5 ml/min/1.73m2) and higher proteinuria (0.9 vs 0.6 g/gCr). CONCLUSION: The patients with IgAN with crescents showed more deteriorated clinicopathological findings than those without crescents. Despite aggressive treatments, they presented a significantly decreased renal function and larger amount of proteinuria after 1 year. So crescents are supposed to have poor effects on the clinical course.
Biopsy ; Blood Pressure ; Capillaries ; Creatinine ; Glomerulonephritis, IGA ; Hematuria ; Humans ; Immunoglobulin A ; Immunohistochemistry ; Polymerase Chain Reaction ; Proteinuria ; Retrospective Studies

A 74-year-old postmenopausal woman visited our gynecology clinic complaining of a palpable abdominal mass. Physical and radiological evaluation indicated that the mass exhibited features of a left ovarian neoplasm showing heterogeneous enhancement. Surgical resection was performed to confirm this suspicion. During surgery, a mass was observed only in the left ovary with no invasive growth, but adhesions to the surrounding peritoneum were seen. Given the patient's age, large mass size, and accompanying uterine myoma and right ovarian cyst, total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. The final pathologic diagnosis was dedifferentiated liposarcoma. The liposarcoma was suspected to originate from retroperitoneal adipose tissue rather than the ovary. Radiotherapy was planned if a gross lesion indicating recurrence followed 6 months later. This case required a considerable multi-disciplinary approach for diagnosis and treatment because of its ambiguous clinical and radiological findings.
Aged ; Diagnosis ; Female ; Gynecology ; Humans ; Hysterectomy ; Intra-Abdominal Fat ; Leiomyoma ; Liposarcoma* ; Ovarian Cysts ; Ovarian Neoplasms ; Ovary ; Peritoneum ; Radiotherapy ; Recurrence ; Retroperitoneal Neoplasms

Eczematous lesions of atopic dermatitis (AD) patients are known to be a source of Staphylococcus aureus (SA) transmission and might be a reservoir for community-associated methicillin-resistant SA (MRSA). The BD Max StaphSR (BD-SR) is a fully automated, multiplex real-time PCR assay for the direct detection and differentiation of SA and MRSA from nasal swab samples. We evaluated the detection rates of SA and MRSA from skin lesions of outpatients with AD using the BD-SR assay, and determined the usefulness of the BD-SR assay. A total of 244 skin swab samples (skin lesions of 213 outpatients with AD and normal skin of 31 healthy controls) were tested directly by using the BD-SR assay. Of the 213 samples from patients with AD, 69 (32.4%) were positive for SA, 6 (8.7%) of which were positive for MRSA. Only 1 (3.2%) of 31 samples from healthy controls was positive for SA. The BD-SR assay is effective for the rapid detection of SA and MRSA from skin swab samples, which can provide important information for managing patients with AD and preventing the spread of MRSA.
Dermatitis, Atopic* ; Humans ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus ; Outpatients ; Real-Time Polymerase Chain Reaction ; Skin ; Staphylococcus aureus* ; Staphylococcus*

BACKGROUND: Atopic dermatitis (AD) is a chronically relapsing skin disease that is associated with a disturbance of the epidermal barrier function. Changes in the human skin microbiome have been suggested as a risk factor for AD. OBJECTIVE: The aim of this study was to explore the species distribution of microflora on the skin and in the oral cavity of healthy volunteers and patients with AD. METHODS: Samples for culture were obtained from both lesional skin and the oral cavity in 211 patients with AD and from both the normal skin and oral cavity of 24 healthy controls. Species identification was performed with the VITEK 2 system (bioMerieux Inc., Hazelwood, MO, USA). RESULTS: The isolation of Staphylococcus aureus from the skin was statistically more frequent among patients with AD than among healthy controls, while the isolation of Staphylococcus hominis and Micrococcus luteus were statistically more frequent among healthy controls than among patients with AD (p<0.05). In the oral cavity, S. aureus and Candida albicans were found more frequently in patients with AD, but the difference did was not statistically significant. CONCLUSION: This study provides an important insight into the species distribution of microorganisms on human skin and in the oral cavity. Further investigation is required to determine the role of specific microorganisms in the etiology and pathogenicity of AD.
Candida albicans ; Dermatitis, Atopic* ; Healthy Volunteers ; Humans ; Microbiota ; Micrococcus luteus ; Mouth ; Risk Factors ; Skin Diseases ; Skin* ; Staphylococcus aureus ; Staphylococcus hominis ; Virulence

BACKGROUND: With increasing use of medical radiologic procedures, wearing proper protector should be emphasized to reduce occupational radiation exposures. This research describes the rates of lead apron wearing for radiation protection and assessed occupational factors related to wearing rates for various types of healthcare professionals. METHODS: We conducted a self-administered questionnaire survey through a website, on-site visits, fax, and mail. Of the 13,489 participants, 8858 workers who could not completely separate themselves from radiological procedure areas. Their general characteristics (sex and age), work history (job title, duration of employment, and hospital type), and practices (frequency of radiation procedures, ability to completely separate from radiation, and frequency of wearing protective lead aprons) were examined. RESULTS: The mean rate of lead apron wearing during radiologic procedures was 48.0 %. The rate was different according to sex (male: 52.9 %, female: 39.6 %), hospital type (general hospital: 63.0 %, hospital: 51.3 %, clinic: 35.6 %, dental hospital/clinic: 13.3 %, public health center: 22.8 %), and job title (radiologic technologist: 50.3 %, doctor: 70.3 %, dentist/dental hygienist: 15.0 %, nurse/nursing assistant: 64.5 %) (p < 0.001). By logistic regression analysis stratified by job title, use of lead aprons by radiologic technologists and nurses/nursing assistants was associated with hospital type and exposure frequency score. For doctors, apron wearing was associated with employment duration. For dentists/dental hygienists, apron wearing was associated with the exposure frequency score. CONCLUSIONS: To improve working environments for healthcare professionals exposed to radiation, it is necessary to consider related factors, such as job title, duration of employment, and hospital type, when utilizing a planning and management system to prevent radiation-related health problems.
Delivery of Health Care* ; Employment ; Female ; Humans ; Logistic Models ; Postal Service ; Public Health ; Radiation Protection