The 56-kilodalton protein genes of Orientia tsutsugamushi TA678, TA686, TA716, TA763 strains were amplified by PCR. The amplified products were sequenced and cloned into pIH821 vector. The recombinant proteins were expressed in Escherichia coli as fusion proteins with maltose binding protein. The recombinant proteins were purified and used for the sensitization of sheep RBCs and the reactivity of the recombinant 56-kDa proteins of Orientia tsutsugamushi TA 678, TA686, TA716 strains were analyzed with 40 sera from scrub typhus patients in Korea, 40 sera from scrub typhus in Thailand, Malaysia and Philippines. The 56-kDa protein coding DNA sequence of Orientia tsutsugamushi TA678, TA686, TA716 show 70 to 88% homology with other known strains and four variable regions are also observed. 39 of 40 sera from scrub typhus patients in Korea showed the strongest reactivity to the recombinant protein of Boryong strain and one sera showed the strongest reactivity to the recombinant protein of Gilliam strain. 14 of 40 sera from patients in Thailand, Malaysia and Philippines showed the strongest reactivity to the recombinant protein of TA686 strain and 12 sera showed the strongest reactivity to the recombinant protein of TA716 strain. No serum from patients in Thailand, Malaysia and Philippines showed the strongest reactivity to the recombinant protein of Boryong strain.
Asian Continental Ancestry Group* ; Base Sequence ; Chungcheongnam-do ; Clinical Coding ; Clone Cells ; Cloning, Molecular* ; Escherichia coli ; Hemagglutination Tests* ; Hemagglutination* ; Humans ; Korea ; Malaysia ; Maltose-Binding Proteins ; Orientia tsutsugamushi* ; Philippines ; Polymerase Chain Reaction ; Recombinant Proteins ; Scrub Typhus ; Sheep ; Thailand

To understand the seroepidemiological patterns of haemorrhagic fever with renal syndrome in Korea, a nation-wide survey collaborated with fourteen clinics was carried out from 1994 to 1996. Sera of 4,547 patients with acute febrile episodes were tested by indirect immunofluorescent antibody test and the seroepidemiological analysis including sex, age, seasonal and regional distributions were performed. According to the results obtained in this study, the epidemiological characteristics of haemorrhagic fever with renal syndrome in Korea were summarized as follows: 1. Seropositive rate of hemorrhagic fever with renal syndrome among the patients with acute febrile episodes was 6.4% by the cut-off point of 1:40. 2. Among the seropositives, male outnumbered female and the ratio of males to females was 2.0:1.0. 3. Seventy six % of the seropositive patients were 21-60 years old. 4. The number of seropositive cases increased from October and reached maximum in December and began to decrease gradually from January. 5. The geographical distribution of the seropositives cover most areas including Cheju province in Korea.
Female ; Fever ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Jeju-do ; Korea* ; Male ; Seasons

Epithelioid hemangioendothelioma is a neoplasm of vascular origin with a low-to-intermediate malignant potential and is one of the rare sarcomas arising from the liver. Its etiology is unknown and its clinical outcome is unpredictable. There is no generally accepted therapeutic strategy because of its rarity and the variable natural course between hemangioma and angiosarcoma. We report a case of a 64-year old woman who underwent hepatic resection due to epithelioid hemangioendothelioma in the right lobe that progressed to extrahepatic metastases of the bone, pleura, and peritoneum 22 months later. However, after resection there was no primary hepatic recurrence.
Bone Neoplasms/diagnosis/pathology/secondary ; Female ; Hemangioendothelioma, Epithelioid/*diagnosis/pathology/*secondary ; Hepatectomy ; Humans ; Liver Neoplasms/*diagnosis/pathology ; Lung Neoplasms/diagnosis/pathology/secondary ; Middle Aged ; Tomography, X-Ray Computed

BACKGROUND/AIMS: The serum Helicobacter pylori IgG antibody test has been widely used by primary care physicians for over two decades. We assessed its usefulness as a screening strategy for organic gastrointestinal disease in routine check-up. METHODS: We retrospectively reviewed the medical records of 10,080 subjects who received a routine check up at the Kangnam St. Mary's Hospital from January 2004 to April 2005. All subjects underwent the H. pylori IgG antibody test and upper gastrointestinal endoscopy or a barium contrast study. RESULTS: The overall seropositive rate for H. pylori detection was 61.0% (6,150/10,180). The 13C-urea breath test (UBT) was performed in 340 subjects. The H. pylori antibody test showed 55% accuracy in comparison to the standard 13C-UBT. The number of patients with peptic ulcer in the seropositive group was 475 (7.7%) compared to only 168 patients (4.3%) in the seronegative group (p<0.001). Stomach cancer was observed in eight (0.1%) and two (0.1%) patients in the seropositive and seronegative groups, respectively. The positive and negative likelihood ratios for the H. pylori IgG antibody test for peptic ulcer were 1.22 and 0.66, respectively, compared to 1.31 and 0.26 for stomach cancer. CONCLUSIONS: In view of its low accuracy and likelihood ratios, we do not recommend the H. pylori antibody test as a diagnostic tool for H. pylori infection or as a screening strategy for organic gastrointestinal disease during routine check-ups.
Barium ; Breath Tests ; Endoscopy, Gastrointestinal ; Gastrointestinal Diseases ; Helicobacter ; Helicobacter pylori ; Humans ; Immunoglobulin G ; Mass Screening ; Medical Records ; Peptic Ulcer ; Physicians, Primary Care ; Retrospective Studies ; Serologic Tests ; Stomach Neoplasms