OBJECTIVES: This study evaluates the change of the left atrial appendage function before and after electrical cardioversion to understand the mechanism involved in systemic thromboembolism of atrial fibrillation. BACKGROUND: Systemic thromboembolism associated with electrical cardioversion of atrial fibrillation is thought to originate from the left atrium or left atrial appendage, or both.However, the mechanism involved is poorly understood. METHOD: We studied left atrial appendage function funcction with transesophageal echocardiography in 15 patients with atrial fibrillation before and after successful electrical cardioversion. We measured left atrial appendage emptying and filling velocities and left atrial appendage areas. Also we analysed the characteristic Dopper flow pattern of LAA. RESULT: Left atrial appendage emptying velocities before cardioversion were greater in patients without(32.0+/-13.2cm/sec) than in those with(21.4+/-7.6cm/sec) spontaneous echo contrast(SEC). Furthermore emptying velocities after cardioversion were significantly reduced group with (21.4+/-7.6 vs 12.2+/-9.6, p<0.05) and the groupwithout(32.0+/-13.2 vs 18.1+/-10.2, p<0.05)SEC. CONCLUSION: After electrical cardioversion for atrial fibrillation left atrial appendage function is impaired. These observations suggest that stunned left atrial appendage after cardioversion may predispose to thrombus formation, which may play a role in the mechanism involved in the occurrence of thromboembolism after cardioversion.
Atrial Appendage* ; Atrial Fibrillation* ; Echocardiography, Transesophageal* ; Electric Countershock* ; Heart Atria ; Humans ; Thromboembolism ; Thrombosis

The purpose of this study is to develop the computerized health instruction system to manage the Health Management Members(HMM) of the Gangbook-ku Health center in Seoul who have registered for the life-time health promotion. The HMM have been checked up and classified into 3 groups - healthy, borderline and ill group - based on their health assessment data through the computerized management system. But the computerized supporting programs for intensive management have not been sufficient enough to offer clear health instructions to the HMM and more than one user in the health center have not been able to use the system at the same time. Therefore, we have developed some new health instruction programs and upgraded the system to be used concurrently. For that purposes, we have used Delphi, Microsoft Access, ActiveX Data Objects(ADO) technology as development tools. We expect thi system to be used for health management of other public health centers, schools, and occupational settings, furthermore for evaluation of health promotion services. Additionally, this new computerized health management system supplemented with health instruction programs should be integrated to the computerized health care system at health centers in near future.
Delivery of Health Care ; Health Promotion ; Humans ; Public Health ; Seoul

PURPOSE: To investigate whether non-Hodgkin's lymphoma of Korea is pathogenetically associated with Epstein-Barr virus (EBV). MATERIALS AND METHODS: We analyzed fifty nine paraffin-embedded tissue and 22 fresh frozen tissue samples from non-Hodgkin's lymphoma patients for the presence of EBV sequences by polymerase chain reactions (PCR), in situ hybridization (ISH) and assessed the clonality of EBV infected cells by Southern blot hybridization. RESULT: On ISH using oligonucleotide probes corresponding to EBV-encoded small RNAs (EBERs), 17 (28.8%) of 59 paraffin-embedded tissue samples showed positive hybridization signals localized over the nuclei of the tumor cells, but PCR using primers from Internal Repeat I or EBV-determined nuclear antigen 1 gene showed positive results in only 6 (10.2%) and 5 (8.5%) samples, respectively. ISH and PCR did not detect EBV sequences in 15 paraffin-embedded tissue samples of tuberculous lymphadenitis patients. In 22 fresh frozen tissue samples, PCR detected EBV sequences in three samples from peripheral T cell lymphoma (PTCL). In two of those three samples, Southern blot analysis showed that these viral DNAs were monoclonal and of latent form. CONCLUSION: Approximately 28.8% of non-Hodgkin's lymphoma were related to EBV in Korea. Monoclonality of those EBV DNAs implies that virus infection preceded malignant transformation, suggesting that EBV may play a role in lymphomagenesis.
Blotting, Southern ; DNA ; DNA, Viral ; Herpesvirus 4, Human* ; Humans ; In Situ Hybridization ; Korea* ; Lymphoma, Non-Hodgkin* ; Lymphoma, T-Cell, Peripheral ; Oligonucleotide Probes ; Polymerase Chain Reaction ; RNA ; Tuberculosis, Lymph Node

Mycobacterium abscessus, a rapidly growing mycobacterium, is an opportunistic pathogen which causes a wide variety of clinical symptoms. Recently non-tuberculous mycobacterial infections are increasing among immunocompromised patients and made 4% of total cases of mycobacterial infection. To our knowledge, there has been no report of systemic infection caused by rapidly growing mycobacterium in Korea. We experienced a case of M. abscessus septicemia due to chemoport infection in a 47-year old female who was diagnosed as ovarian cancer stage IIIc and was in the immunocompromised state after systemic chemotherapy. The patient manifested with fever, chilling, headache, and nausea, though, there were no abnormalities on physical examination. When the patient was receiving empirical antibiotic therapy, a rapidly growing mycobacterium was detected in repeated blood cultures. She was improved with not only systemic an-tibiotic treatment but also removing the chemoport. But short course (4 weeks) of antibiotic therapy caused incomplete treatment and made multiple skin abscess. After incision and drainage of the lesions and administration of prolonged antibiotic therapy, no additional infection was observed. Based on our experience and the review of the literatures, catheter-related bacteremia due to rapidly growing mycobacterium, including M. abscessus, should be treated with catheter removal and appropriate antibiotic therapy for at least 3 to 6 months based on in vitro susceptibility testing. When a patient in neutropenic state presents sustained fever after treatment with conventional antibiotics, non-tuberculous mycobacterial infection should be considered.
Abscess ; Anti-Bacterial Agents ; Bacteremia ; Catheters ; Drainage ; Drug Therapy ; Female ; Fever ; Headache ; Humans ; Immunocompromised Host ; Korea ; Middle Aged ; Mycobacterium* ; Nausea ; Ovarian Neoplasms ; Physical Examination ; Sepsis* ; Skin

Mycobacterium genavense, first identified in 1990, is known as a pathogen that mimics disseminated Myocobacterium avium-intracellulare complex (MAC) infection with particular propensity for the gastrointestinal tract. In Korea, no case with the organism has been reported. Herein we report a case of Mycobacterium genavense infection that manifested with erosive lesion of duodenum in a patient with acquired immune deficiency syndrome. The patient presented with epigastric pain and fever, diarrhea. Duodenal biopsy showed histiocytic infiltration with numerous acid-fast bacilli. Identification of the mycobacterial isolate by the polymerase chain reaction restriction analysis of 16S rRNA gene revealed Mycobacterium genavense.
Acquired Immunodeficiency Syndrome ; Biopsy ; Diarrhea ; Duodenum* ; Fever ; Gastrointestinal Tract ; Genes, rRNA ; HIV Infections* ; HIV* ; Humans ; Korea ; Mycobacterium* ; Polymerase Chain Reaction

Mycobacterium genavense, first identified in 1990, is known as a pathogen that mimics disseminated Myocobacterium avium-intracellulare complex (MAC) infection with particular propensity for the gastrointestinal tract. In Korea, no case with the organism has been reported. Herein we report a case of Mycobacterium genavense infection that manifested with erosive lesion of duodenum in a patient with acquired immune deficiency syndrome. The patient presented with epigastric pain and fever, diarrhea. Duodenal biopsy showed histiocytic infiltration with numerous acid-fast bacilli. Identification of the mycobacterial isolate by the polymerase chain reaction restriction analysis of 16S rRNA gene revealed Mycobacterium genavense.
Acquired Immunodeficiency Syndrome ; Biopsy ; Diarrhea ; Duodenum* ; Fever ; Gastrointestinal Tract ; Genes, rRNA ; HIV Infections* ; HIV* ; Humans ; Korea ; Mycobacterium* ; Polymerase Chain Reaction

To detect Rickettsia, we have developed a nested PCR method amplifying the groEL gene. Rickettsia strains were successfully amplified by this PCR method but the microorganisms causing other febrile diseases, such as Orientia tsutsugamushi, Coxiella burnetii, Ehrlichia sennetsu, Borrelia burgdorferi sensu lato, Borrelia hermsii, and Leptospira interrogans were not amplified. This PCR assay was applied to detect Rickettsia DNA from 100 ticks. Sixteen Haemaphysalis longicornis ticks were positive by this PCR assay. These results suggest that the new nested PCR method might be sensitive and useful for discrimination between Rickettsia and other febrile disease-causing microorganisms.
Borrelia ; Borrelia burgdorferi Group ; Coxiella burnetii ; Discrimination (Psychology) ; DNA ; Leptospira interrogans ; Neorickettsia sennetsu ; Orientia tsutsugamushi ; Polymerase Chain Reaction* ; Rickettsia* ; Ticks

BACKGROUND: Fluoroquinolone drugs are an important anti-tuberculous agent for the treatment of multi-drug resistant tuberculosis. However, many drugs belonging to the fluoroquinolones have different cross resistance to each other. METHODS: Sixty-three ofloxacin (OFX) resistant and 10 pan-susceptible M. tuberculosis isolates were selected, and compared for their cross resistance using a proportion method on Lowenstein-Jensen media, containing ofloxacin (OFX), ciprofloxacin (CIP), levofloxacin (LVX), moxifloxacin (MXF), gatifloxacin (GAT) and sparfloxacin (SPX), at concentrations ranging from 0.5 to 3microgram/ml. DNA extracted from the isolates was directly sequenced after amplifying from the gyrA and gyrB genes. RESULTS: The 63 OFX resistant M. tuberculosis isolates showed complete cross resistance to CIP, but only 90.5, 44.4, 36.5 and 46.0% to LVX, MXF, GAT, and to SPX, respectively. Fifty-one of the isolates (81.0%) had point mutations in codons 88, 90, 91 and 94 in gyrA, which are known to be correlated with OFX resistance. The Gly88Ala, Ala90Valand Asp94Ala mutations in gyrA showed a tendency to be susceptible to MXF, GAT and SPX. Only 4 isolates had mutations in the gyrB gene, which did not affect the OFX resistance. CONCLUSION: About 60% of the OFX resistant M. tuberculosis isolates were susceptible to GAT, SPX and MXF. These fluoroquinolones may be useful in the treatment of TB patients showing OFX resistance.
Ciprofloxacin ; Codon ; DNA ; Fluoroquinolones ; Genotype ; Humans ; Levofloxacin ; Mycobacterium tuberculosis* ; Mycobacterium* ; Ofloxacin ; Point Mutation ; Tuberculosis ; Tuberculosis, Multidrug-Resistant

The plasminogen and plasmin system, which is mainly regulated by urokinase-type plasminogen activator (uPA), its receptor (uPAR) and its inhibitor (PAI-1), is generally believed to play a role in cancer invasion and metastasis. This study was conducted to investigate the role of uPA, uPAR and PAI-1 in the invasion and metastasis of gastric adenocarcinoma. The expression of mRNAs for uPA and PAI-1 was determined by Northern blot analysis in nine primary gastric cancer tissues, nine paired metastatic lymph nodes and normal gastric mucosa. The mRNA of uPA was not or faintly detected in normal mucosa, while the expression was increased in both primary gastric cancer tissues and metastatic lymph nodes to a similar degree. The mRNA expression for PAI-1 in the gastric cancer tissues was not different from that in the paired metastatic lymph nodes and normal mucosae. uPAR was determined by immunohistochemical staining, demonstrating that five (56%) and six (67%) out of nine primary gastric cancer tissues and nine paired metastatic lymph nodes were positive, respectively and the intensity was stronger in metastatic lymph nodes. The results support the concept that most gastric cancer cells may have an innately moderate level of uPA and uPAR, and that increase of uPAR expression can be considered to be closely associated with cancer invasion and metastasis.
Adenocarcinoma/*metabolism/pathology ; Gastric Mucosa/metabolism ; Gene Expression ; Human ; Immunoenzyme Techniques ; Lymph Nodes/metabolism/pathology ; Neoplasm Metastasis ; Plasminogen Activator Inhibitor 1/*biosynthesis/genetics ; Plasminogen Activators/*biosynthesis/genetics ; RNA, Messenger/biosynthesis ; Receptors, Cell Surface/*biosynthesis/genetics ; Stomach Neoplasms/*metabolism/pathology ; Support, Non-U.S. Gov't ; Urinary Plasminogen Activator/*biosynthesis/genetics

The human cytomegalovirus(HCMV) gene encoding the protein reactive with the sera of HCMV-infected patient was cloned and characterized. A reactive phage clone was screened from a lambda gt11 expression library of cDNA of HCMV AD169 strain using HCMV-infected patient sera. The recombinant protein was expressed as 138 kDa-fusion protein with beta-galactosidase, which was reactive with IgM or IgG HCMV antibody-positive sera, but not with anti-HCMV antibody-negative sera. A homology search of the DNA sequence of the cloned gene with HCMV AD169 sequences revealed that it was composed of 709 base pairs spanning between 0.174 and 0.177 map units of the UL32 region of the HCMV AD169 strain genome. This position corresponded to a part of the gene encoding 150 kDa phosphoprotein-(pp150), a major tegument protein, which was reported as an immunogenic protein which evoked strong and longstanding antibody response and had no sequence homology with the proteins of other herpesviruses. These results suggested that pp150 was an immunogenic protein in natural HCMV infection and therefore this clone was regarded as a useful candidate for developing an antigen for the serodiagnosis of HCMV.
Antibodies, Viral/*blood/immunology ; Antigens, Viral/*genetics/immunology ; Cloning, Molecular ; Cytomegalovirus/genetics/*immunology ; Cytomegalovirus Infections/blood/*immunology/virology ; DNA, Complementary/genetics ; DNA, Viral/genetics ; Gene Library ; *Genes, Structural, Viral ; Human ; Recombinant Fusion Proteins/biosynthesis/immunology ; Sequence Homology, Nucleic Acid ; Support, Non-U.S. Gov't ; Viral Matrix Proteins/*genetics/immunology