PURPOSE: We investigated the operative outcome after bypass surgery in patients selected using viability criteria on F-18 FDG PET. MATERALS AND METHODS: Rest-24hr delay redistribution imaging of Tl-201 SPECT and F-18 FDG PET were performed in 11 patients. Seven of these 11 patients (6 men, 1 woman) were evaluated to have viable myocardium by F-18 FDG PET. Changes in symptoms and left ventricular ejection fraction (LVEF) after operation were evaluated. RESULTS: In seven of 11 patients, a significant amount of viable myocardium was found on F-18 FDG PET and Tl-201 SPECT. Severity of both chest pain and dyspnea improved markedly in all patients. Mean LVEF improved from 22% to 32%. CONCLUSION: F-18 FDG PET could be used to select the patients who will benefit from coronary artery bypass surgery.
Cardiomyopathies* ; Chest Pain ; Coronary Artery Bypass ; Dyspnea ; Humans ; Male ; Myocardium ; Positron-Emission Tomography ; Stroke Volume ; Tomography, Emission-Computed, Single-Photon

BACKGROUND: In this study, we compared various methods of taxonomic identification of Bacillus strains: biochemical methods, 16S rRNA gene sequencing, and matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS). We also developed a pathogen- isolate resource database, thus increasing the identification rate when using MALDI-TOF MS. METHODS: Thirty Bacillus strains were obtained from the NCCP (National Culture Collection for Pathogens) and were identified using the VITEK 2 system (bio-Mérieux, France), API kit (bioMérieux, France), 16S rRNA gene sequencing, and MALDI-TOF MS. The pathogenicity of Bacillus cereus was confirmed through the identification of virulent genes using a multiplex PCR, and both protein extraction for protein profiling in MALDI-TOF MS and repetitive-sequence fingerprinting were performed. RESULTS: The identification rates at the species level were 40%, 80%, and 76.3% for the VITEK 2 system (bioMérieux), 16S rRNA gene sequencing, and MALDI-TOF MS, respectively. When the major spectrum-profiling dendrogram was compared with the phylogenetic tree, which was constructed based on the 16S rRNA gene sequences and rep-PCR fingerprinting, the classifications were confirmed to be effective. CONCLUSION: Identification of Bacillus strains using MALDI-TOF MS was more effective than that using the VITEK 2 system (bioMérieux), but was similar to that using 16S rRNA gene sequencing. Continual addition to a proteome-based database can result in increased identification rates for MALDI-TOF MS.
Bacillus cereus ; Bacillus* ; Classification ; Dermatoglyphics ; Genes, rRNA ; Mass Spectrometry* ; Multiplex Polymerase Chain Reaction ; Trees ; Virulence

Species identification is an important item to characterize unidentified bacterial pathogens in developing and managing bacterial resources. In this study, unidentified pathogens based on the results of an automated identification system were identified using matrix assisted laser desorption ionization-time of flight mass spectrometry (MALD-TOF MS) and 16S rRNA gene analysis for development of national resources in the National Culture Collection for Pathogens (NCCP) in Korea. A total of 437 unidentified strains from branch banks of the NCCP were collected, and 16S rRNA and dnaJ gene sequencing, as well as MALDI-TOF MS analysis were performed to identify bacterial species. The mass spectra extracted were analyzed. Twelve strains exhibiting less than 98.65% similarity in 16S rRNA gene were selected as the primary candidates for novel species, and 21 strains exhibiting 98.65~99.0% similarity in 16S rRNA gene were selected as possible candidates for novel species. Among them, strain 32, belonging to Dermabacter sp., was finally selected as a possible strain representing a novel species and 14 unidentified bacterial strains using automated phenotypic identification system were newly registered at NCCP. The present study showed that unidentified pathogens using the automated phenotypic identification system were efficiently identified using the combination of MALDI-TOF MS and 16S rRNA gene analysis, and developed to the national resources in NCCP.
Genes, rRNA* ; Korea ; Mass Spectrometry

BACKGROUND: Viral antigens presented on the cell surface in association with MHC class I molecules are recognized by CD8+ T cells. MHC restricted peptides are important in eliciting cellular immune responses. As peptide antigens have a weak immunigenicity, pH-sensitive liposomes were used for peptide delivery to induce effective cytotoxic T lymphocyte (CTL) responses. In the previous study, as the HBx peptides could induce specific CTLs in vitro, we tested whether the HLA-A2/K(b) transgenic mice that were immunized by HBx-derived peptides could be protected from a viral challenge. METHODS: HBx-peptides encapsulated by pH-sensitive liposomes were prepared. A2K(b) transgenic mice were immunized i.m. on days one and seven with the indicated concentrations of liposome-encapsulated peptides. Three weeks later, mice were infected with 1X10(7) pfu/head of recombinant vaccinia virus (rVV)-HBx via i.p. administration. The ovaries were extracted from the mice, and the presence of rVV-HBx in the ovaries was analyzed using human TK- 143B cells. IFN-gamma secretion by these cells was directly assessed using a peptide-pulsed target cell stimulation assay with either peptide-pulsed antigen presenting cells (APCs), concanavalin A (2microg/ml), or a vehicle. To generate peptide-specific CTLs, splenocytes obtained from the immunized mice were stimulated with 20nicrog/ml of each peptide and restimulated with peptide-pulsed APC four times. The cytotoxic activity of the CTLs was assessed by standard (51)Cr-release assay and intracellular IFN-gamma assay. RESULTS: Immunization of these peptides as a mixture in pH-sensitive liposomes to transgenic mice induced a good protective effect from a viral challenge by inducing the peptide-specific CD8+ T cells. Mice immunized with 50microg /head were much better protected against viral challenge compared to those immunized with 5microg/head, whereas the mice immunized with empty liposomes were not protected at all. After in vitro CTL culture by peptide stimulation, however, specific cytotoxicity was much higher in the CTLs from mice immunized with 5microg/head than 50microg/head group. Increase of the number of cells that intracellular IFN-gamma secreting cell among CD8+ T cells showed similar result. CONCLUSION: Mice immunized with XEPs within pH-sensitive liposome were protected against viral challenge. The protective effect depended on the amount of antigen used during immunization. XEP-3-specific CTLs could be induced by peptide stimulation in vitro from splenocytes obtained from immunized mice. The cytotoxic effect of CTLs was measured by (51)Cr-release assay and the percentage of accumulated intracellular IFN-gamma secreting cells after in vitro restimulation was measured by flow cytometric analysis. The result of (51)Cr-release cytotoxicity test was well correlated with that of the flow cytometric analysis. Viral protection was effective in immunized group of 50microg/head, while in the in vitro restimulation, it showed more spectific response in 5microg/head group.
Animals ; Antigen-Presenting Cells ; Antigens, Viral ; Concanavalin A ; Female ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Immunity, Cellular ; Immunization ; Liposomes ; Lymphocytes ; Mice ; Mice, Transgenic* ; Ovary ; Peptides* ; T-Lymphocytes* ; Vaccinia virus

PURPOSE: This report presents a procedure for performing power Doppler ultrasound-guided sialography using the phenomenon of increased blood flow and illustrates its application to practical patient cases.MATERIALS AND METHODS: The salivary gland was scanned using ultrasound equipment (GE LOGIQ5 Expert® device; GE Medical Systems, Milwaukee, WI, USA) to identify pathological findings related to the patient's chief complaint. To identify the orifice of the main duct, it should be cannulated using a lacrimal dilator. After inserting the catheter into the cannulated main duct, the position of the catheter within the duct was confirmed by ultrasound. A contrast agent was injected until the patient felt fullness, and ultrasound (B-mode) was used to confirm whether the contrast agent filled the main canal and secondary and tertiary ducts. Then, power Doppler ultrasound was performed to determine whether the salivary gland had increased blood flow.RESULTS: In 2 cases in this report, a power Doppler ultrasound scan showed a significant increase in blood flow after contrast medium injection, which was not observed on a preoperative scan.CONCLUSION: Power Doppler ultrasound was found to be a simple, safe, and effective tool for real-time sialography monitoring.
Catheters ; Humans ; Salivary Glands ; Sialography ; Ultrasonography ; Vasodilation

Hereditary angioedema (HAE) is a rare autosomal dominant disorder caused by genetic deficiency or decreased function of C1-esterase inhibitor. It is characterized by swelling of subcutaneous and submucosal tissues of the extremities, gastrointestinal tract, and upper airways which can be life-threatening. Thus, early recognition and treatment of the disease are important. Short- and longterm prophylaxes are used to decrease the severity and frequency of attacks. Icatibant is a selective bradykinin B2-receptor antagonist, earlier treatment of acute attacks and hospital admission. The authors present a case of 47-year-old woman who was diagnosed with type II HAE, danazol as a long term. Her symptoms improved dramatically after drug treatment. The unpredictability and recurrence of HAE attacks could have a negative impact on social life and quality of life. This case shows that timely and proper treatment could improve quality of life and reduce morbidity and mortality. (

Decalcification of the buccal surface of the teeth often occurs during fixed orthodontic treatment. This case report describes two cases in which cervical decalcificated teeth that occurred during orthodontic treatment were treated with direct resin veneer restoration. Early lesions without caries can be remineralized through periodic fluoride application, diet control, and oral hygiene improvement. As it progresses, appropriate repair treatment is required, and it is more preferable to focus on prevention rather than treatment after the occurrence of the lesion.

The overexpression of X-linked inhibitor of apoptosis protein (XIAP), a member of IAP family protein, is intuitively expected to be associated with unfavorable clinical features in malignancies; however, there have been only a very limited number of studies reporting the clinical relevance of XIAP expression. This study was performed to investigate the prognostic relevance of XIAP expression in childhood acute myeloid leukemia (AML). In 53 children with de novo AML, the level of XIAP expression was determined by using quantitative reverse transcriptase-polymerase chain reaction and was analyzed with respect to the clinical characteristics at diagnosis and treatment outcomes. As a result, the XIAP expression was found to be higher in patients with extramedullary disease than in those without (P=0.014). In addition, XIAP overexpression (> or =median expression) was associated with an unfavorable day 7 response to induction chemotherapy and also associated with a worse 3-yr relapsefree survival rate (52.7+/-20.9% vs. 85.9+/-14.8%, P=0.014). Multivariate analyses revealed that XIAP overexpression was an independent unfavorable prognostic factor for relapse-free survival (hazard ratio, 6.16; 95% confidence interval, 1.48-25.74; P=0.013). Collectively, XIAP overexpression may be used as an unfavorable prognostic marker in childhood AML.
Adolescent ; Child ; Child, Preschool ; Female ; Gene Expression Regulation, Leukemic ; Humans ; Infant ; Leukemia, Myeloid, Acute/*diagnosis/drug therapy/mortality ; Male ; Prognosis ; Reverse Transcriptase Polymerase Chain Reaction ; Survival Rate ; X-Linked Inhibitor of Apoptosis Protein/*metabolism

PURPOSE: Peripheral neuropathy (PN) is known as a major contributor of the worsening of ischemic symptoms and the foot ulceration in patients with peripheral arterial occlusive disease (PAOD). However, there are few studies reporting the prevalence and risk factors for PN in PAOD. This study aimed to evaluate these issues for PN and to establish the importance of screening as additional treatment target for PN in PAOD. MATERIALS AND METHODS: A total of 52 limbs with PAOD were enrolled from January 2011 to December 2012. PN was divided into radiculopathy, ischemic PN (IPN), and diabetic PN (DPN), based on electromyographic findings. We investigated the prevalence of overall PN and subtypes of PN and then analyzed the risk factors. RESULTS: The prevalence of overall PN in PAOD was 43 of 52 limbs (82.7%). In terms of subtypes of PN, the prevalence rate of radiculopathy and IPN was 30.8% and 23.1%, respectively. DPN showed in 22 limbs (73.3%) among 30 diabetic limbs. There was no significant correlation between each type of PN and ischemic symptoms. Our analysis showed that coronary artery disease (CAD) was a significant risk factor (P=0.01) for IPN, however, did not identify any significant risk factors for DPN. CONCLUSION: This present study indicated that most patients with PAOD had PN and CAD was a risk factor for IPN. In particular, PAOD with diabetes represented a higher prevalence for DPN. Our study suggests that PN should be evaluated and considered as another treatment target in patients with PAOD.
Arterial Occlusive Diseases* ; Coronary Artery Disease ; Extremities ; Foot Ulcer ; Humans ; Mass Screening ; Peripheral Nervous System Diseases* ; Prevalence* ; Radiculopathy ; Risk Factors*

Chronic virus infection leads to the functional impairment of dendritic cells (DCs) as well as T cells, limiting the clinical usefulness of DC-based therapeutic vaccine against chronic virus infection. Meanwhile, B cells have been known to maintain the ability to differentiate plasma cells producing antibodies even during chronic virus infection. Previously, alpha-galactosylceramide (alphaGC) and cognate peptide-loaded B cells were comparable to DCs in priming peptide-specific CD8+ T cells as antigen presenting cells (APCs). Here, we investigated whether B cells activated by alphaGC can improve virus-specific T cell immune responses instead of DCs during chronic virus infection. We found that comparable to B cells isolated from naive mice, chronic B cells isolated from chronically infected mice with lymphocytic choriomeningitis virus (LCMV) clone 13 (CL13) after alphaGC-loading could activate CD1d-restricted invariant natural killer T (iNKT) cells to produce effector cytokines and upregulate co-stimulatory molecules in both naive and chronically infected mice. Similar to naive B cells, chronic B cells efficiently primed LCMV glycoprotein (GP) 33-41-specific P14 CD8+ T cells in vivo, thereby allowing the proliferation of functional CD8+ T cells. Importantly, when alphaGC and cognate epitope-loaded chronic B cells were transferred into chronically infected mice, the mice showed a significant increase in the population of epitope-specific CD8+ T cells and the accelerated control of viremia. Therefore, our studies demonstrate that reciprocal activation between alphaGC-loaded chronic B cells and iNKT cells can strengthen virus-specific T cell immune responses, providing an effective regimen of autologous B cell-based therapeutic vaccine to treat chronic virus infection.
Animals ; Antibodies ; Antigen-Presenting Cells ; B-Lymphocytes ; Clone Cells ; Cytokines ; Dendritic Cells ; Glycoproteins ; Lymphocytic choriomeningitis virus ; Mice ; Natural Killer T-Cells ; Plasma Cells ; T-Lymphocytes ; Viremia