Nosocomial opportunistic infections including fungal infections continue to increase with a longer survival of immunocompromised patients. Disseminated candidiasis is the most common nosocomial fungal infection and the frequency of isolation of non-Candida albicans organisms besides C.albicans is increasing as causative organisms. We detected numerous yeast cells incidentally in a peripheral blood smear of an infant with congenital heart disease who was treated with total parenteral nutrition and catheterization, and had a history of antibiotics use during a long hospitalization period. Pichia anomala was isolated from the blood and pleural effusion.
Anti-Bacterial Agents ; Candidiasis ; Catheterization ; Catheters ; Fungi ; Heart Defects, Congenital ; Hospitalization ; Humans ; Immunocompromised Host ; Infant ; Opportunistic Infections ; Parenteral Nutrition, Total ; Pichia* ; Pleural Effusion ; Yeasts

BACKGROUND: There is some evidence linking the infections with common organisms such as Chlamydophila pneumoniae, cytomegalovirus (CMV), Helicobacter pylori and HIV to myocardial infarction (MI). We had performed a serologic study to assess whether C.pneumoniae, CMV, H. pylori and HIV infections are associated with MI. METHODS: Serum samples were obtained from 54 cases of acute MI, 33 cases of old MI, and 60 normal controls. C-reactive protein (CRP) as an inflammation marker was measured and antibodies to C.pneumoniae, CMV, H.pylori and HIV were assayed by ELISA. Odds ratios (OR) were calculated against control group. RESULTS: CRP was significantly higher in the acute MI and old MI group. ORs of C.pneumoniae infection increased considerably in the acute MI (IgM 1.57, IgG 4.80) and old MI group (IgM 2.42, IgG 5.18). ORs of CMV infection were 3.30 in the acute MI and 5.12 in old MI group. ORs of H. pylori infection showed below 1 in the acute MI and old MI. Anti-HIV antibody showed all negative result in three groups, so OR could not be calculated. CONCLUSION: C.pneumoniae and CMV infections appear to be risk factors for MI.
Antibodies ; C-Reactive Protein ; Chlamydial Pneumonia* ; Chlamydophila pneumoniae* ; Chlamydophila* ; Coronary Artery Disease ; Cytomegalovirus* ; Enzyme-Linked Immunosorbent Assay ; Helicobacter pylori* ; Helicobacter* ; HIV Infections* ; HIV* ; Immunoglobulin G ; Inflammation ; Myocardial Infarction* ; Odds Ratio ; Risk Factors

BACKGROUND: Although there are growing evidences linking Chlamydophila pneumoniae infection to myocardial infarction, it remains controversial. The authors intended to assess whether C. pneumoniae infection is associated with myocardial infarction. METHODS: Sera and peripheral mononuclear cells (PMNCs) were collected from 54 cases of acute myocardial infarction (MI), 33 cases of old MI, and 60 normal controls. Anti-C.pneumoniae IgG and IgM antibodies were measured using a microimmunofluorescence (mIF) method, and C.pneumoniae DNA was detected using polymerase chain reaction (PCR). RESULTS: Seropositivity of anti-C.pneumoniae IgM antibody by mIF was shown 5.0% in control group, 29.6% (OR=8.00) in the acute MI and 6.1% (OR=1.23) in old MI group. Seropositivity of anti C.pneumoniae IgG antibody were 60.0 % in control group, 92.6% (OR=8.33) in the acute MI and 87.9% (OR= 4.83) in old MI group. The antibody titers in the acute MI and old MI group tended to be higher compared to those in control group. No C.pneumoniae DNA was detected in any case by PCR. CONCLUSION: The seropositivity and antibody titers were significantly higher in the acute MI and old MI group than in control group, suggesting that C.pneumoniae infection may be a risk factor for myocardial infarction.
Antibodies ; Chlamydial Pneumonia* ; Chlamydophila pneumoniae* ; Chlamydophila* ; DNA ; Immunoglobulin G ; Immunoglobulin M ; Myocardial Infarction* ; Pneumonia ; Polymerase Chain Reaction ; Risk Factors

BACKGROUND: Analysis of reticulated platelets (RPs) is useful for discriminating the causes of thrombocytopenia and monitoring the thrombopoiesis. In the patients with severe thrombocytopenia, we evaluated the thrombopoiesis-discriminating ability of several indices applying forward scatter (FSC) and thiazole orange (TO) fluorescence in addition to the percentage of reticulated platelets (RPs%). METHODS: Forty cases with decreased thrombopoiesis, twenty cases with increased thrombopoiesis and twenty cases with liver cirrhosis were selected. By flow cytometry with two analytic methods, dependent on or independent of the staining of CD41-PE as a platelet marker, the primary parameters including RPs% were measured and the applied parameters were calculated from them. And we compared the diagnostic efficiency of each parameter and analyzed the purity of platelet light scatter gate. RESULTS: The purity of platelet light scatter gate was significantly lower in patients with severe thrombocytopenia than in healthy persons with normal platelet counts (P<10(-6)), so the use of CD41-PE for platelet gating improved the diagnostic efficiency of RPs%. Compared to the primary parameters, the applied parameters originated from RPs%, FSC and TO fluorescence improved diagnostic efficiency significantly (RPs%: 55%, RPs%xs delta MFI: 80%) between decreased and increased thrombopoiesis groups. CONCLUSIONS: In the patients with severe thrombocytopenia, the estimate of the thrombopoiesis by a flow cytometric analysis can be more predictable by using platelet markers and by considering the fluorescence intensity of TO together with the RPs%.
Blood Platelets ; Citrus sinensis ; Flow Cytometry ; Fluorescence ; Humans ; Liver Cirrhosis ; Platelet Count ; Thrombocytopenia* ; Thrombopoiesis*

BACKGROUND: This study was purposed to find out the differences in the lymphocyte subsets and differential cell counts of the bronchoalveolar lavage (BAL) fluid in patients with interstitial lung disease (ILD) and to analyze the differences according to their ages, gender and smoking habits. METHODS: BAL fluid samples of 141 ILD patients were examined for lymphocyte subsets and differential cell counts, and the differences among the patients were analyzed according to their diseases. Then, within the three most common disease groups, the differences were further analyzed by the age, gender and smoking habit of the patients. RESULTS: There were no statistically significant differences in total cell counts (per millimeters of BAL fluid) among the patient groups with each ILD. However, significant differences were observed in the percentages of neutrophils, lymphocytes, eosinophils, and macrophages of BAL fluid. Also, in lymphocyte subset analyses, the percentages of total T cells, B cells, CD4+ T cells, CD8+ T cells, CD4/CD8 T cell ratios, and NK cells were significantly different among the patients with each ILD. However, within the same disease group, there were no differences in differential cell counts and lymphocyte subset analyses according to the age, smoking habit, and gender of the patients. CONCLUSIONS: Although the age, smoking habit and gender did not have an effect on the BAL fluid analyses among the patients with the same ILD, there were significant differences among the patients with each ILD; therefore, the differential cell counts and lymphocyte subset analyses of BAL fluid can be useful in differential diagnosis for determining the types of ILD.
Adult ; Aged ; Bronchoalveolar Lavage Fluid/*cytology ; Diagnosis, Differential ; Female ; Humans ; Lung Diseases, Interstitial/diagnosis/*epidemiology/etiology ; Lymphocyte Count ; Lymphocyte Subsets/immunology ; Male ; Middle Aged ; Smoking

BACKGROUND: TT virus (TTV), isolated initially from a Japanese patient with posttransfusion hepatitis of unknown etiology, was suggested to be a new causative agent of hepatitis. However, it has been found to infect both healthy and diseased individuals and numerous studies have raised questions about its pathogenic role in hepatitis. In order to study its prevalence and clinical impact on hepatitis, we assessed the frequency of TTV DNA. METHODS: Serum samples were obtained from 60 cases of the controls, 77 cases of chronic liver diseases, 44 cases of hemodialyzed patients, and 65 cases of transfused patients. TTV DNA was detected using nested polymerase chain reaction and alanine aminotransferase (ALT), aspartate aminotransferase (AST), and hepatitis B surface antigen (HBsAg) were measured. RESULTS: TTV DNA was detected in 41.7% of the controls, 51.9% of patients with chronic liver diseases, 68.2% of hemodialyzed patients and 61.5% of transfused patients. Comparison between patients with or without TTV revealed no significant differences in AST, ALT, and HBsAg test results. CONCLUSION: The prevalance of TTV infection in patients with chronic liver diseases was similar to that in the controls. TTV infection was not related to abnormal liver function findings and HBsAg positivity. We found no relationship between TTV infection and chronic liver diseases.
Alanine Transaminase ; Asian Continental Ancestry Group ; Aspartate Aminotransferases ; DNA ; Hepatitis ; Hepatitis B Surface Antigens ; Humans ; Liver Diseases* ; Liver* ; Polymerase Chain Reaction ; Prevalence ; Renal Dialysis* ; Torque teno virus*

BACKGROUND: Allogeneic or autologous bone marrow transplantation (BMT) or peripheral blood stem cell transplantation (PBSCT) has been settled a modality of treatment in hematologic malignantdisorders or solid tumors. Because engraftment or not was important for the direction of treatment and prognosis of the patients, various methods, judging it early were groped. Instead of an absoluteneutrophil count (ANC) or platelet count in PB, we used reticulocyte parameters as early predictors of hematopoietic engraftment. METHODS: We measured the ANC with reticulocyte parameters daily in 25 patients receiving allogeneic BMT or PBSCT (n=17, 30.82+/-9.97 years old) and autologous PBSCT (n=8, 30.63+/-8.55 years old) from January 2002 to February 2003 in Kyungpook National University Hospital. Wedefined erythroid engraftment as the first day of a mean corpuscular volume of reticulocyte (MCVr)>or=105 fL and immature reticulocyte fraction (IRF) >or=10% in the second rising peak and myeloid engraftment as the first day of ANC >or=500/microL. RESULTS: The erythroid engraftment occurred after a mean time of 16.24+/-4.16 days in allogeneic graft and 14.00+/-3.55 days in autologous graft and the myeloid engraftment occurred 17.94+/-3.23 days and 15.00+/-2.78 days, respectively. In the allogeneic graft, the erythroid engraftment occurred earlier than the myeloid engraftment (P=0.03). In the autologous graft, the erythroid engraftment preceded the myeloid engraftment; however, it was not statistically significant (P=0.47). Among 3 cases, wherein the erythroid engraftment occurred later than the myeloid engraftment in allogeneic graft, 2cases were ABO-incompatible PBSCT. CONCLUSIONS: Considering that the successive increase of immature reticulocytes preceded that of ANC in most cases, we concluded that as an early indicator of hematopoietic engraftment, reticulocyte parameters such as IRF and MCVr were useful especially observing them simultaneously.
Bone Marrow Transplantation ; Erythrocyte Indices ; Gyeongsangbuk-do ; Humans ; Peripheral Blood Stem Cell Transplantation ; Platelet Count ; Prognosis ; Reticulocytes* ; Stem Cell Transplantation* ; Transplants

BACKGROUND: We investigated the interactions between spontaneous apoptosis-induced neutrophils and autoantibodies with attention to the reactivities of each autoantibody against intracellular antigenssuch as the antinuclear antibody (ANA) and the anti-neutrophil cytoplasmic antibody (ANCA) and the applicability as a conventional test for autoantibody detection. METHODS: The 127 serum samples from patients with autoimmune disease were mixed with whole blood from healthy donors and incubated for 20 hours. The bound antibody against substrate neutrophils was detected with anti-IgG-FITC by flow cytometry. The results of this anti-long incubated neutrophil antibody (ALINA) testing were compared with ANA, ANCA and clinical manifestations. RESULTS: The positivity rate was significantly higher in the 20 hour incubation than that of a 30 minute incubation (100% and 18%, respectively; P<0.000005). Agreement analyses between ANCA and ALINA (k=0.34) and between ANA and ALINA (k=0.39) were poor. In comparison, among the autoimmune diseases, systemic lupus erythematosus had a significantly higher ALINA positivity rate than did other diseases (P<0.000005). In patients with SLE, higher mean fluorescence intensity was significantly associated with the presence of lupus nephritis (11/12 cases vs. 2/10 cases, P<0.005). CONCLUSIONS: We detected antibodies against neutrophil antigens expressed by long incubation with patient sera. Those detected autoantibodies were significantly associated with SLE, especially lupus nephritis. Therefore, further studies are necessary to devise optimal protocols and to clarify specificities for detected autoantibodies or their target antigens.
Antibodies* ; Antibodies, Antineutrophil Cytoplasmic ; Antibodies, Antinuclear ; Autoantibodies ; Autoimmune Diseases ; Flow Cytometry* ; Fluorescence ; Humans ; Lupus Erythematosus, Systemic ; Lupus Nephritis ; Neutrophils* ; Tissue Donors

BACKGROUND: We investigated the interactions between spontaneous apoptosis-induced neutrophils and autoantibodies with attention to the reactivities of each autoantibody against intracellular antigenssuch as the antinuclear antibody (ANA) and the anti-neutrophil cytoplasmic antibody (ANCA) and the applicability as a conventional test for autoantibody detection. METHODS: The 127 serum samples from patients with autoimmune disease were mixed with whole blood from healthy donors and incubated for 20 hours. The bound antibody against substrate neutrophils was detected with anti-IgG-FITC by flow cytometry. The results of this anti-long incubated neutrophil antibody (ALINA) testing were compared with ANA, ANCA and clinical manifestations. RESULTS: The positivity rate was significantly higher in the 20 hour incubation than that of a 30 minute incubation (100% and 18%, respectively; P<0.000005). Agreement analyses between ANCA and ALINA (k=0.34) and between ANA and ALINA (k=0.39) were poor. In comparison, among the autoimmune diseases, systemic lupus erythematosus had a significantly higher ALINA positivity rate than did other diseases (P<0.000005). In patients with SLE, higher mean fluorescence intensity was significantly associated with the presence of lupus nephritis (11/12 cases vs. 2/10 cases, P<0.005). CONCLUSIONS: We detected antibodies against neutrophil antigens expressed by long incubation with patient sera. Those detected autoantibodies were significantly associated with SLE, especially lupus nephritis. Therefore, further studies are necessary to devise optimal protocols and to clarify specificities for detected autoantibodies or their target antigens.
Antibodies* ; Antibodies, Antineutrophil Cytoplasmic ; Antibodies, Antinuclear ; Autoantibodies ; Autoimmune Diseases ; Flow Cytometry* ; Fluorescence ; Humans ; Lupus Erythematosus, Systemic ; Lupus Nephritis ; Neutrophils* ; Tissue Donors

BACKGROUND: Silver has extensive and powerful antimicrobial activities and silver-containing materials have been widely used in many medical fields. Recently nanoparticulate silver was developed and it is superior to other types of silver in the antimicrobial activity and cytotoxicity. There have been no data from Korea on its antimicrobial activity, and we evaluated the antimicrobial activity of NANOVER against common clinical isolates. METHODS: Minimum inhibitory concentrations (MICs) of NANOVER for clinical isolates were determined using the agar dilution method of Clinical and Laboratory Standard Institute. A total of 45 isolates were tested including 4 reference strains (Staphylococcus aureus ATCC 25923, Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 27853, Enterococcus faecalis ATCC 29212), 5 strains of methicillin-resistant S.aureus (MRSA), 7 strains of methicillin-sensitive S. aureus (MSSA), 14 strains of E.coli,and 15 strains of P. aeruginosa. RESULTS: The MICs of S.aureus to NANOVER were under 12.5 microgram/mL regardless of the methicillin sensitivity or resistance. The other isolates showed the MICs under 12.5 to 6.25 microgram/mL. CONCLUSION: NANOVER has strong and extensive antimicrobial activities to common clinical isolates including those resistant to other antimicrobials.
Agar ; Enterococcus faecalis ; Escherichia coli ; Korea ; Methicillin ; Methicillin Resistance ; Microbial Sensitivity Tests ; Nanoparticles* ; Pseudomonas aeruginosa ; Silver*