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Hepatitis G Virus Infection Rate in Blood Donors, Hemodialysis Patients and Hepatitis C Infected Patients.

Ki Youn KIM ; Seong Chul KIM ; Won Kil LEE ; Jay Sik KIM ; Jang Soo SUH ; Kyung Eun SONG ; Dong Kyu CHO ; Jong Gyu KIM ; Dal Hyo SONG

Korean Journal of Clinical Pathology.1998;18(3):433-441.

BACKGROUND: A recently identified Flaviviridae-like agent, termed hepatitis G virus (HGV), has been recognized as a non A-E hepatitis agent, but its relation to liver disease and transmission mode are not well understood. We investigated HGV infection rate in Korea and tried to clarify its relation to the liver disease. METHODS: 145 blood donors, 39 hemodialysis patients and 22 hepatitis C virus (HCV) infected persons were investigated for the presence of HGV by nested reverse transcriptase polymerase chain reaction (nested RT-PCR) with primers from the 5' UTR of HGV and some liver function tests. In each PCR assay, one positive and two negative controls were included. RESULTS: HGV-RNA was detected in 11 (7.6%) of 145 young voluntary blood donors and in 5 (12.8%) of 39 hemodialysis patients and in 8 (36.4%) of 22 HCV infected patients. All HGV RNA positive hemodialysis patients have a past history of transfusion, but they had a remarkably shorter duration of hemodialysis than those of HGV-negative patients. HCV infected patients with HGV-RNA tended to be younger than those without HGV-RNA. In all 15 HGV-RNA infected individuals without hepatitis B and C infection, alanine amino transferase was not increased except in 2 cases. Liver function tests did not show a significant difference between HGV-RNA positive patients and negative patients. CONCLUSIONS: Hepatitis G virus infection rate was much higher in Korea than other countries, so we suggested that group life could be another transmission mode other than blood transfusion. But even in infected cases, HGV did not seem to cause hepatitis and a high proportion cleared the virus after a relatively short time.
5' Untranslated Regions ; Alanine ; Blood Donors* ; Blood Transfusion ; GB virus C* ; Hepacivirus ; Hepatitis B ; Hepatitis B virus ; Hepatitis C* ; Hepatitis* ; Humans ; Korea ; Liver Diseases ; Liver Function Tests ; Polymerase Chain Reaction ; Renal Dialysis* ; Reverse Transcriptase Polymerase Chain Reaction ; RNA ; Transferases

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Distribution of Hepatitis C Virus Serotypes of HCV RNA Positive Subjects in Korea.

Seon Ho LEE ; Sung Ryul KIM ; Chul Hun CHANG ; Han Chul SON ; Soon Ho KIM

Korean Journal of Clinical Pathology.1998;18(3):425-432.

BACKGROUND: The geographical prevalence of the genotypes of hepatitis C virus (HCV) is variable, with which the response to therapy is associated. The HCV genotypes based on PCR and serological genotypes (serotypes) are known to be highly correlated with each other. In spite of the ease of the test, there was no reported data of HCV serotypes in Korean. So, the serotypes in Korean was evaluated for the construction of the basic data. METHODS: The HCV serotypes were tested by Murex HCV serotyping 1-6 Assay kit in persons with normal or high ALT. At the same time, anti-HCV and HCV RNA were detected. RESULTS: Positive rates of anti-HCV were 6.0% in persons with high ALT, with increasing tendency in aging process, which were higher than 1.4% in normal persons. HCV RNA was positive in 49% of persons with anti-HCV positive. The serotypes were detectable in 92.4% of persons with HCV RNA positive, of which type 1 and 2 were 51.6% and 40.8%, respectively. CONCLUSIONS: Serotype 1 and 2 were the major type in Korean, which data would be useful for the further study on the correlation of the serotypes with the genotypes and the relationship of the serotypes and the responses to therapy.
Aging ; Genotype ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Korea* ; Polymerase Chain Reaction ; Prevalence ; RNA* ; Serotyping

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Diagnostic Availability of the Soluble Transferrin Receptor in RA Patients.

Lae Hee CHUN ; Think You KIM ; Hye Rim LEE ; Woong Soo LEE

Korean Journal of Clinical Pathology.1998;18(3):420-424.

BACKGROUND: The transferrin receptor (TfR) is expressed on almost all cellular surfaces and is shedded into the blood to form the soluble transferrin receptor (sTfR). The sTfR has been known to be a good marker to reflect cellular iron status and to differentiate between iron deficiency anemia (IDA) and anemia of chronic disease (ACD) without the need for a bone marrow aspiration in rheumatoid arthritis (RA) patients. So we aimed to evaluate the diagnostic availability of sTfR in patients with RA and degenerative joint disease (DJD). METHODS: Eighty-seven outpatients visiting the Department of Rheumatology at HYUH were studied and divided into anemic and non-anemic groups according to their Hb levels (female< 12 g/dL, male< 14 g/dL). The sTfR was measured by ELISA method (Quantikine IVDTM, R&D system). To differentiate whether the anemia was due to iron deficiency or other causes, we used the RBC parameters and a discriminant index which was calculated from serum iron, ferritin and TIBC instead of a bone marrow aspiration, an invasive procedure of which interpretation can be subjective. RESULTS: The median was higher (31.09 nM) than the normal reference values (9-28 nM) only in the anemic group of RA. The medians were within normal limit in all the other groups. sTfR levels were high in 15 of the 28 RA anemic patients which were composed of 10 patients with IDA, 4 with non-anemic RA and 1 with non-anemic RA & DJD. CONCLUSIONS: In the present study, sTfR was increased not only in IDA but also in ACD of RA patients and also in non-anemic patients, which showed that sTfR cannot be used to differentiate these two types of anemia by itself and the further tests are needed. We conclude that the expression of TfR in RA patients was dependent not only on iron deficiency but also on the disease itself.
Anemia ; Anemia, Iron-Deficiency ; Arthritis, Rheumatoid ; Bone Marrow ; Chronic Disease ; Enzyme-Linked Immunosorbent Assay ; Ferritins ; Humans ; Iron ; Joint Diseases ; Outpatients ; Receptors, Transferrin* ; Reference Values ; Rheumatology ; Transferrin*

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Comparison of the Hybrid Capture Assay and Polymerase Chain Reaction for the Detection of Hepatitis B Virus DNA.

So Young KIM ; Moon Hee CHOI ; Mi Ae LEE ; Wha Soon CHUNG

Korean Journal of Clinical Pathology.1998;18(3):414-419.

BACKGROUND: Various molecular methods such as polymerase chain reaction (PCR) and DNA hybridization have been introduced to diagnose the hepatitis B more accurately. Recently, Hybrid Capture Assay (HCA) was developed, which uses the signal amplification solution hybridization capture assay with chemiluminescent detector. So we evaluated the sensitivity and clinical utility of the HCA and PCRs for the detection of hepatitis B virus DNA (HBV DNA) and compared these results with serologic markers. METHODS: We analysed the 50 samples from the hepatitis B patients using enzyme immunoassay, HCA and nested PCRs with two different primer sets. The primers of PCR I and PCR II were targeted to pol and core region respectively. RESULTS: In 18 cases, HBV DNA were detected by HCA in which the positive rates by PCR I and PCR II were 55.6%, and 88.9%, respectively. And in 32 cases in which HBV DNA by HCA was negative, the positive rates by PCR I and PCR II were 6.2% and 31.3%, respectively. In 44 cases which were positive for HBsAg, the positive rates for HBV DNA were 38.6% by HCA, 27.3% by PCR I, and 56.8% by PCR II. In cases positive for HBeAg, the positive rates were 93.3% by HCA, 60.0% by PCR I and 80.0% by PCR II. In cases positive for anti-HBe and negative for HBeAg, the positive rates were 10.3% by HCA, 10.3% by PCR I, and 44.8% by PCR II. CONCLUSIONS: Both HCA and PCR compensated each other yet as to the accurate investigation of the viral replication in patients with hepatitis B and the sensitivity was better in HBV PCR with primers to core region than to pol region.
DNA ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Immunoenzyme Techniques ; Polymerase Chain Reaction*

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Early Detection of Human Cytomegalovirus DNA by PCR-ELISA.

Min KIM ; Myung YOON ; Woo Hyun LIM ; Jong Hee SHIN ; Soon Pal SUH ; Dong Wook RYANG

Korean Journal of Clinical Pathology.1998;18(3):407-413.

BACKGROUND: Human cytomegalovirus (CMV) infections are common and occasionally severe in newborns, immunocompromised hosts, cancer patients, and recipients of organ transplant. Consequently, sensitive and rapid methods for CMV detection are of great diagnostic value since antiviral drugs have become available, which might be more effective upon early administration. We evaluated a polymerase chain reaction and enzyme-linked immunosorbent assay (PCR- ELISA) to detect human CMV infection as an aid in making a prompt diagnosis and a determination of therapeutic efficacy. METHODS: CMV DNA was amplified by single PCR, using primers chosen from genomic regions (major immediate-early [MIE] protein coding region), and the microwell plate hybridization assay was performed for specific detection of 5'-biotinylated PCR products using CMV-specific probes labeled with digoxigenin. A total of 35 clinical specimens from 14 patients who were suspected CMV infectious state was analyzed by PCR-ELISA and its results were compared with those of serum anti-CMV IgM, shell vial culture assay and PCR. RESULTS: The sensitivity for detection of PCR-amplified CMV DNA by the ELISA was 102 copies, which was ten-fold greater than ethidium bromide staining of agarose gels. The positive rates of 35 clinical specimens by serology, shell vial culture assay, PCR and PCR-ELISA were 37.9%, 40.0%, 60.0% and 68.6%, respectively. The OD ranges of 24 positive specimens by PCR-ELISA were from 0.042 to above 2.5. In follow-up studies of two patients with bone marrow transplantation, positive CMV results by PCR-ELISA earlier than by other methods including serologic method, shell vial culture assay and PCR. CONCLUSIONS: These results reveal that PCR-ELISA may show higher sensitivity and positive rate than serologic method, shell vial culture assay and conventional PCR. PCR-ELISA can be useful to manage CMV infection rapidly in patients at risk.
Antiviral Agents ; Bone Marrow Transplantation ; Clinical Coding ; Cytomegalovirus* ; Diagnosis ; Digoxigenin ; DNA* ; Enzyme-Linked Immunosorbent Assay ; Ethidium ; Follow-Up Studies ; Gels ; Humans* ; Immunocompromised Host ; Immunoglobulin M ; Infant, Newborn ; Polymerase Chain Reaction ; Sepharose ; Transplants

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Unusual Morphology of Aberrant Forms of Bacteria in Urine: Presented with Grotesque-Giant Form with Central Emptiness and Fusiform Ends.

Ae Seek KIM ; Jong Chan KANG ; Sun Hwa LEE

Korean Journal of Clinical Pathology.1998;18(3):403-406.

Unusual morphology of aberrant forms of bacteria, presented with grotesque-giant form, 15 m 3 m, with central emptiness and fusiform ends was observed in urine Gram stain from a 26-year-old woman who was admitted with the symptoms of acute urinary tract infection. On wet smear, these bacilli were markedly swollen, yeast-like organisms. In addition to normal shaped bacilli, various shapes of another aberrant bacteria, such as long bacilli, filamentous form, filamentous form with central bulge, and bipolar staining with central emptiness were also observed in the same specimen. The morphologic characteristics of these unusual aberrant bacilli were more distinct on Papanicolaou stain than on Gram stain. In Korea, where antimicrobial agents are overused and disused, the frequency of observing the aberrant bacteria would be much higher than cases reported. Here we report unusual morphology of aberrant forms of Escherichia coli with the emphasis on awaring of the potential appearance of such bacilli in clinical specimen and avoiding confusion with fungi and other naturally filamentous organisms.
Adult ; Anti-Infective Agents ; Bacteria* ; Escherichia coli ; Female ; Fungi ; Humans ; Korea ; Urinary Tract Infections

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Erysipelothrix rhusiopathiae Bacteremia in a Hemodialysis Patient.

Hee Bong SHIN ; Dongeun YONG ; Kyungwon LEE ; Yunsop CHONG ; Dae Suk HAN

Korean Journal of Clinical Pathology.1998;18(3):399-402.

Erysipelothrix rhusiopathiae, a facultatively anaerobic, gram-positive rod, has long been an important pathogen in veterinary medicine. Recently E. rhusiopathiae has become more commonly recognized as a cause of serious diseases in humans, such as endocarditis- associated ones. Identifying E. rhusiopathiae is difficult as this organism may be mistaken for Streptococcus or just dismissed as a contaminant. E. rhusiopathiae was isolated from a blood specimen obtained from a 65-year-old man, who had chronic renal failure. His recent contact history with animal was not available. The isolate showed typical cultural and biochemical characteristics such as growth on both aerobic and anaerobic media, formation of small, greenish colonies on blood agar, positive hydrogen sulfide in TSI agar, and absence of motility and catalase reaction. The isolate was resistant to vancomycin in disk diffusion test and in Etest. In conclusion, in case of unidentified gram-positive bacterial sepsis, one should be aware of E. rhusiopathiae as a possible pathogen.
Agar ; Aged ; Animals ; Bacteremia* ; Catalase ; Diffusion ; Erysipelothrix* ; Humans ; Hydrogen Sulfide ; Kidney Failure, Chronic ; Renal Dialysis* ; Sepsis ; Streptococcus ; Vancomycin ; Vancomycin Resistance ; Veterinary Medicine

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A Case of Wound Infection Caused by Staphylococcus aureus with Decreased Susceptibility to Teicoplanin.

Yeon Joon PARK ; Myungshin KIM ; Byung Kee KIM ; Sun Moo KIM ; Sang In SHIM

Korean Journal of Clinical Pathology.1998;18(3):396-398.

With increased infection by methicillin-resistant staphylococci, the use of glycopeptides has been increasing. Recently, staphylococci with decreased susceptibility to glycopeptides, especially teicoplanin, are increasingly reported. We isolated a Staphylococcus aureus strain isolated repeatedly from a wound culture, which showed susceptibility to teicoplanin by the disk diffusion method but showed growth on the Mueller-Hinton agar containing 6 g/mL of teicoplanin. This strain was clinically resistant to treatment at 200 mg/day of teicoplanin. By changing the treatment into combining rifampin (600 mg/day) and increasing the dose of teicoplanin (400 mg/day), the S. aureus was not isolated any more.
Agar ; Diffusion ; Glycopeptides ; Methicillin Resistance ; Rifampin ; Staphylococcus aureus* ; Staphylococcus* ; Teicoplanin* ; Wound Infection* ; Wounds and Injuries*

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Comparison of Susceptibility Test and mecA Detection for Determination of Methicillin Resistance in Staphylococcus epidermidis.

Jong In PARK ; Jeong Nyeo LEE

Korean Journal of Clinical Pathology.1998;18(3):391-395.

BACKGROUND: Staphylococcus epidermidis is a leading cause of nosocomial infections, and resistance to methicillin is common in clinical isolates. The distribution of oxacillin MIC for S. epidermidis is not clearly bimodal and it is suspected that the sensitivities for detection of oxacillin resistance by standard susceptibility assays with National Committee for Clinical Laboratory Standards (NCCLS) MIC interpretive criteria (< OR =2 g/mL, > OR =4 g/mL) in S. epidermidis strains are lower than that in Staphylococcus aureus strains. To evaluate the relationship between MIC results and true methicillin resistance, we examined the oxacillin MICs and methicillin MICs by agar dilution and detection of mecA gene by PCR for 41 S. epidermidis strains. METHODS: A total of 41 S. epidermidis strains were examined antimicrobial susceptibility test by VITEK system with GPS-AA card, oxacillin MICs and methicillin MICs by agar dilution and detection of mecA gene by PCR. RESULTS: In antimicrobial susceptibility test by VITEK system with GPS-AA card, 24 strains (58.5%) showed oxacillin resistance. 13 strains (31.7%) required MICs of > OR =4 g/mL in oxacillin MIC test and 19 strains (46.3%) required MICs of > OR =16 g/mL in methicillin MIC test. But 27 strains (65.9%) were mecA positive. One of 15 strains that required oxacillin MICs of < OR =0.5 g/mL, all 3 strains that required oxacillin MICs of 1 g/mL and all 10 strains that required oxacillin MICs of 2 g/mL were mecA positive. CONCLUSIONS: It is suspected that NCCLS MIC interpretive criteria underestimate methicillin resistance among S. epidermidis strains and the PCR method is a reliable reference method.
Agar ; Cross Infection ; Methicillin Resistance* ; Methicillin* ; Oxacillin ; Polymerase Chain Reaction ; Staphylococcus aureus ; Staphylococcus epidermidis* ; Staphylococcus*

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Serotypes and Biochemical Reaction Patterns of Group B Streptococci.

Young UH ; In Ho JANG ; Gyu Yel HWANG ; Kap Jun YOON

Korean Journal of Clinical Pathology.1998;18(3):386-390.

BACKGROUND: This study is designed to provide data on the trend of serotypes of group B streptococci (GBS) isolated from clinical specimens during recent eight years and to elucidate the relationship between biochemical reactions and serotypes of GBS. METHODS: Serotyping, pigment production test, CAMP test, hippurate hydrolysis, and hemolysis test were performed for 150 GBS isolates from clinical specimens during March 1990 to February 1998. The typing sera used were Ia, Ib, II, III, IV, and V. Pigment production was detected by new Granada tube medium. The CAMP test and hippurate hydrolysis were performed by standard technique. Hemolytic patterns of GBS were determined on sheep blood agar and human blood agar plate. RESULTS: GBS were frequently isolated from cervix, urine, wound (pus), and blood. Striking increase of GBS isolates were notified from 1996 to 1997 period. Identification rates of GBS serotypes were Ib (38.0%), III (37.3%), Ia (9.3%), V (8.7%), nontypable strains (4.0%), and II (2.7%) in decreasing order. The proportion of serotype III increased markedly from 1996. Serotype V was not isolated until 1996, and ranked third in 1997. Seven (4.7%) isolates were nonhemolytic, and six of seven isolates revealed serotype III. Two (1.3%) isolates that were negative in both CAMP test and hippurate hydrolysis were serotype II. CONCLUSIONS: Clinical microbiology laboratories relying on beta hemolysis or pigment production for initial detection of GBS may underestimate the isolation rate of GBS and the proportion of serotype III which hardly makes hemolysis. It is therefore recommended that laboratories providing cultures for the GBS of genitalia specimens supplement other detection methods such as CAMP test or immunologic methods.
Agar ; Cervix Uteri ; Female ; Genitalia ; Hemolysis ; Humans ; Hydrolysis ; Serotyping ; Sheep ; Strikes, Employee ; Wounds and Injuries

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