We produced two murine monoclonal antibodies designated S2E1 and S2C11, which recognize S antigen of hepatitis B virus (HBsAg). S2E1 could bind to denatured form of recombinant HBsAg as well as native form of HBsAg, but S2C11 could bind only to native form of HBsAg. Both antibodies reacted with HBsAg in the hepatocyte of patient infected with hepatitis B virus. Analyses of the nucleotide sequences encoding the variable regions of these antibodies revealed that S2E1 and S2C11 utilize variable gene segment which belong to V4/5 gene family and utilize the J5 and Jk4 gene segments, respectively. In addition, the heavy chain of S2E1 express a member of V14 gene family and a member of DSP2.9 and Jh3 gene families. S2C11 is related to the V1 gene family and expresses DFL16.1 gene regions in conjunction with the Jh3 gene segment.
Antibodies ; Antibodies, Monoclonal* ; Base Sequence ; Clone Cells* ; Cloning, Organism* ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Hepatocytes ; Humans

OBJECTIVE: The aim of this study was to estimate the feasibility, safety and surgical outcomes of single port access laparoscopic myomectomy (SPA-M). METHODS: We reviewed the medical records of 29 patients with uterine leiomyoma who underwent SPA-M in Gumi CHA hospital between March 2010 and August 2010. We performed SPA-M with conventional rigid straight laparoscopic instruments in all cases. RESULTS: In this study, the mean of leiomyoma weight, operating time, and estimated blood loss were 55.43 gm(+/-54.79, range 5~220 gm), 69.68 min (+/-32.99, range 20~120 min.), 100 mL (+/-104.26 range minimal~300 mL), respectively. Transfusion was done in the one case. CONCLUSION: SPA-M using conventional rigid straight laparoscopic instruments was feasible and could be an alternative to conventional multi-port access laparoscopic myomectomy (MPA-M).
Humans ; Leiomyoma ; Medical Records

We present herein an unusual case of multilocular thymic cyst, with prominent lymphoid follicular hyperplasia, in a 64-year-old man. It was incidentally founded as a mediastinal mass on chest radiography, during a routine health check-up. Computed tomography revealed a cystic lesion, which contains thick septa involving the thymus. The resected mass, 8x4 cm in diameter, involved the thymus and there is no adhesion or invasion into the adjacent tissue. The cut surface showed cystic spaces with thick white-tan firm wall, which cysts contained gelatinous material. Microscopically, the lesion was characterized by multiple cysts, lined by flattened cuboidal epithelium that was separated by thick walls, having a dense lymphoid tissue with lymphoid follicles. The patient was discharged without any complication and is well without evidence of recurrence for sixteen months.
Epithelium ; Gelatin ; Humans ; Hyperplasia ; Lymphoid Tissue ; Mediastinal Cyst ; Mediastinal Diseases ; Middle Aged ; Recurrence ; Thorax ; Thymus Gland

Klebsiella pneumoniae has been reported to be the most common pathogen causing pyogenic liver abscess. K. pneumoniae liver abscess occurs fairly often in patients with diabetes mellitus, and is commonly associated with metastatic infections such as brain abscess, endophthalmitis, lung abscess, osteomyelitis, prostatitis, necrotizing fasciitis and infection in other sites. Although septic pulmonary embolism (SPE) is uncommon, it is a serious metastatic complication of K. pneumoniae liver abscess. Chest computed tomography (CT) scans are crucial in making the early diagnosis of SPE; however, it does not provide the basis for a definitive diagnosis. A 70-year-old man was referred to the Department of Pulmonology due to cough and an abnormal chest radiography. The chest CT scans revealed relatively well-demarcated, round multiple nodules with peripheral preponderance, cavitary mass in the right upper lobe of the lung and low-density hepatic cystic masses. Bronchoscopic examination and percutaneous needle aspiration of the lung were performed, but there was no evidence of malignancy. Finally, K. pneumoniae was grown from a bronchial washing specimen and blood culture. Intravenous carbapenem was administered over a 3-week period and follow-up CT scans showed improvement in both the lung and the liver. We report a case of K. pneumoniae liver abscess complicated with SPE requiring differential diagnosis of hematogenous metastatic malignancy on CT scans in an elderly patient.
Aged ; Brain Abscess ; Cough ; Diabetes Mellitus ; Diagnosis ; Diagnosis, Differential ; Early Diagnosis ; Endophthalmitis ; Fasciitis, Necrotizing ; Follow-Up Studies ; Humans ; Klebsiella pneumoniae* ; Klebsiella* ; Liver Abscess* ; Liver Abscess, Pyogenic ; Liver* ; Lung ; Lung Abscess ; Needles ; Osteomyelitis ; Pneumonia ; Prostatitis ; Pulmonary Embolism* ; Pulmonary Medicine ; Radiography ; Thorax ; Tomography, X-Ray Computed

The purpose of this paper is to show the clinical and radiologic features of a variety of diffuse, infiltrative breast lesions, as well to review the relevant literature. Radiologists must be familiar with the various conditions that can diffusely involve the breast, including normal physiologic changes, benign disease and malignant neoplasm.
Adult ; Aged ; Aged, 80 and over ; Breast Diseases/*diagnosis/pathology ; Breast Neoplasms/diagnosis/pathology/secondary ; Female ; Humans ; Magnetic Resonance Imaging ; Mammography ; Middle Aged ; Tomography, X-Ray Computed ; Ultrasonography, Mammary

Our society is aging rapidly, and the number of elderly people who are in charge of purchasing and preparing foods at home is increasing. However, most the elderly have difficulty managing nutrition and food safety by themselves. The purpose of this study was to develop the necessary knowledge, through focus group interview and Delphi technique to establish a food safety and nutrition education program. The diet and educational needs of the elderly were surveyed through FGI. The education topics were decided by the Delphi technique. The education program consisted of a five week program, and the topics taught were 'Dietary Change for Healthy Life', 'Prevention of Food Poisoning in Everyday Life', 'Safe Food Handling for my Health', 'Healthy Dietary Life to Prevent Chronic Disease', and 'Safety! Nutrition! Healthy Dietary Life'. This education program was designed to decrease the perceived barriers, and to increase the perceived interests and the sense of self-efficacy. Education program materials, lesson plans, slides, handouts, videos, leaflets, and booklets were developed. Based on the results, the contents of the food safety guideline leaflets for the elderly were decided as the following: (1) wash your hands in the correct way; (2) select safe food; (3) cook foods safely; (4) keep foods safely; (5) keep kitchen utensils clean. In conclusion, if advanced education programs are implemented and delivered continuously in locations such as health centers and community welfare centers, those will contribute significantly to enhance the perception of food safety and to change the desirable dietary behavior of the elderly.
Aged ; Aging ; Delphi Technique ; Diet ; Fees and Charges ; Focus Groups ; Food Handling ; Food Safety ; Foodborne Diseases ; Hand ; Humans ; Pamphlets

Objective: Autologous bone grafting for cranioplasty is associated with a high infection rate and bone absorption. Synthetic implant materials for cranioplasty have been developed. In this study, we evaluated the efficacy of titanium mesh-type patient-specific implants (PSIs) for patients with skull defects using the dice similarity coefficient (DSC), clinical outcomes, and artifacts caused by implants. Methods: This retrospective study included 40 patients who underwent cranioplasty with a titanium mesh PSI at our institution. Based on preoperative and postoperative computed tomography scans, we calculated DSC and artifacts. Results: The calculated DSC of 40 patients was 0.75, and the noise was 13.89% higher in the region of interest (ROI) near the implanted side (average, 7.64 hounsfield unit [HU]±2.62) than in the normal bone (average, 6.72 HU±2.35). However, the image signal-to-noise ratio did not significantly differ between the ROI near the implanted side (4.77±1.78) and normal bone (4.97±1.88). The patients showed no significant perioperative complications that required a secondary operation. Conclusion Titanium mesh-type PSIs for cranioplasty have excellent DSC values with lower artifacts and complication rates.

Prevention and diagnosis of postcontrast acute kidney injury (AKI) after contrast-enhanced computed tomography is burdensome in outpatient department. We investigated whether an electronic alert system could improve prevention and diagnosis of postcontrast AKI. Methods: In March 2018, we launched an electronic alert system that automatically identifies patients with a baseline estimated glomerular filtration rate of <45 mL/min/1.73 m2, provides a prescription of fluid regimen, and recommends a follow-up for serum creatinine measurement. Participants prescribed contrast-enhanced computed tomography at outpatient department before and after the launch of the system were categorized as historical and alert group, respectively. Propensity for the surveillance of postcontrast AKI was compared using logistic regression. Risks of AKI, admission, mortality, and renal replacement therapy were analyzed. Results: The historical and alert groups included 289 and 309 participants, respectively. The alert group was more likely to be men and take diuretics. The most frequent volume of prophylactic fluid in historical and alert group was 1,000 and 750 mL, respectively. Follow-up for AKI was more common in the alert group (adjusted odds ratio, 6.00; p < 0.001). Among them, incidence of postcontrast AKI was not statistically different. The two groups did not differ in risks of admission, mortality, or renal replacement therapy. Conclusion: The electronic alert system could assist in the detection of high-risk patients, prevention with reduced fluid volume, and proper diagnosis of postcontrast AKI, while limiting the prescribing clinicians’ burden. Whether the system can improve long-term outcomes remains unclear.

Background: Recently, microbiome research has been actively conducted for various skin areas. However, no study has yet compared the microbiome of bacteria and fungi in the ear canal of healthy individuals and patients with chronic otitis externa in Korea. Objective: This study aimed to investigate the difference in the distribution of fungal and bacterial microbial communities in ear canal samples of healthy individuals and patients with chronic otitis externa. Methods: In 24 patients with bilateral chronic otitis externa and 24 healthy controls, cotton swabs were used to obtain samples from the bilateral ear canal. To characterize the fungal and bacterial communities, we sequenced and analyzed the 16S rRNA V4–V5 and ITS1 regions using Quantitative Insights into Microbial Ecology 2, respectively. Results: The alpha diversity analysis for bacteria and fungi confirmed that both richness and evenness decreased in the patient group. The beta diversity analysis for bacteria confirmed that these parameters differed between the control and patient groups. The beta diversity analysis for fungi showed no difference between the groups. Conclusion We observed different skin microbiomes in the patients with chronic otitis externa compared with those in the healthy individuals.

PURPOSE: Pneumonia is a common condition in patients with chronic renal insufficiency, and the condition is closely associated with high mortality and hospitalization rate in such patients. However, limited information is available about the clinical course of pneumonia in these patients, particularly in those with coexistent pulmonary atelectasis. We studied the characteristics of pneumonia as well as the clinical significance of pulmonary atelectasis in patients with chronic renal insufficiency. METHODS: We retrospectively reviewed the medical records of 25 patients with chronic renal insufficiency that were diagnosed as having pneumonia with atelectasis. The clinical, laboratory and radiological findings in these patients were examined. We also assessed the severity of atelectasis in these patients and compared the clinical courses of patients with different grades of atelectasis. RESULTS: The mean age of the patients was 71 years, and 15 of the 25 patients (60%) had diabetes. On chest computed tomography, the incidence of lobar infiltration, atelectasis, and pleural effusion was 75%, 64%, and 56%, respectively. The incidences of severe pneumonia and death tended to increase with the severity of atelectasis; however the increase was not statistically significant. The incidence of recurrence of pneumonia was significantly higher in patients with severe atelectasis than that in those without atelectasis. CONCLUSION: The incidence of severe pneumonia and the mortality rate tended to be higher in patients with severe atelectasis than in those without atelectasis. In addition, severe atelectasis was associated with the recurrence of pneumonia in patients with chronic renal insufficiency.
Hospitalization ; Humans ; Incidence ; Medical Records ; Pleural Effusion ; Pneumonia ; Pulmonary Atelectasis ; Recurrence ; Renal Insufficiency, Chronic ; Retrospective Studies ; Thorax