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Frequency of Mutation of Codon 249, Overexpression of p53, and Hepatitis B Virus DNA Positivity in Hepatocellular Carcinoma.

Geon PARK ; Sook Jin JANG ; Ho Jong JEON ; Seong Hwan KIM ; Mi Ja LEE ; Jin Hee KIM ; Sung Heui SHIN ; Bidur Prasad CHAULAGAIN ; Dong Min KIM ; Dae Soo MOON ; Young Jin PARK

Korean Journal of Clinical Microbiology.2007;10(2):84-89.

BACKGROUND: In hepatocellular carcinoma (HCC), the frequency of p53 mutation and the association with hepatitis B virus (HBV) infection varies with geographic locations and risk factors. The aim of this study was to determine the frequency of codon 249 mutation of p53, p53 overexpression, and HBV DNA positivity and to observe the relationship between them in Korean HCC. METHODS: We analyzed overexpression of p53 in hepatoma tissue from 17 HCC patients by immunohistochemistry (IHC), specific mutations at the third base position of codon 249 by PCR-restriction fragment length polymorphism (PCR-RFLP) method, and presence of HBV by nested PCR. RESULTS: Although a point mutation at codon 250 was seen in one (5.8%) of 17 patients, no codon 249 mutations were found in the patient cohort. The p53 protein was overexpressed in 4 (23.5%) of 17 HCCs. PCR for HBV DNA from HCCs showed a positivity rate of 82.4% (14 of 17 specimens). CONCLUSION: In HCC of this study, HBV infection was not associated with either 249 mutation or overexpression of p53, and overexpression of p53 protein seemed to be related to other than this mutation.
Carcinoma, Hepatocellular* ; Codon* ; Cohort Studies ; DNA ; Geographic Locations ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Immunohistochemistry ; Point Mutation ; Polymerase Chain Reaction ; Risk Factors

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Performance Evaluation of TaqMan Probe Method for BK Virus DNA Quantification by Real-time Polymerase Chain Reaction.

Hee Young CHUNG ; Yoo Li KIM ; Kyung Ah HWANG ; Byung Hoo CHOI ; Sook Ja PARK ; Heung Sup SUNG ; Mi Na KIM

Korean Journal of Clinical Microbiology.2007;10(2):77-83.

BACKGROUND: We evaluated the performance of a newly developed real-time polymerase chain reaction (PCR) method using TaqMan probe (TP) and internal control (IC) for quantitation of BK virus (BKV) DNA. METHODS: PCR primers and TP were targeted for the VP1 of BKV and 300 bp-region of VP1 was cloned to prepare a standard DNA. Threshold cycles (Ct) of IC was set at 33+/-3. The recovery rates, precision, linearity, and limit of detection (LOD) were measured using the standard DNA. To correlate TP with previous hybridization probe (HP) method, Ct of those were compared using 35 HP-positive and 15 HP-negative specimens, and the interpretation agreement was analyzed in 63 consecutive clinical specimens including 32 urines and 31 plasmas. Fifty-three53 specimens measured for IC were analyzed for positive rates and levels of BKV according to Ct of IC. RESULTS: The average recovery rate was 101.1% and intra-assay and inter-assay coefficiency variations were 0.017~0.059 and 0.036, respectively, with the specimens of 3 log/mL, and 0.041~0.063 and 0.045, respectively, with the specimens of 6 log/mL. LOD was 183 copies/mL and linearity range was 2.7 log- 12 log/mL. Ct of TP were correlated with those of HP with the function of y=0.8912x+0.3164 (R2=0.9062). Among 63 clinical specimens, 16 were positive in TP and 12 were positive in HP with an agreement of 90.4%. Ct of IC were over 36 in 31 specimens (22 urines and 9 plasmas), of which BKV DNA was much higher in 7 (22.5%) BKV-positive specimens (5.9+/-1.7 log/mL) than in 4 (18.1%) BKV-positive specimens (3.9+/-1.0 log/mL) of 22 having Ct of IC < or =36.; 5.9+/-1.7 vs. 3.9+/-1.0 log/mL. CONCLUSION: TP warrants to be a reliable method for quantification of BKV. IC seemed to be essential to differentiate false-negative results or underestimation of BKV in clinical specimens, especially in urine.
BK Virus* ; Clone Cells ; DNA* ; Limit of Detection ; Plasma ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction*

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Fungemia due to Exophiala dermatitidis.

Eun Sun JEONG ; Jong Hee SHIN ; Myung Geun SHIN ; Soon Pal SUH ; Dong Wook RYANG

Korean Journal of Clinical Microbiology.2010;13(3):135-139. doi:10.5145/KJCM.2010.13.3.135

We report a rare case of fungemia due to Exophiala (Wangiella) dermatitidis in a 4-month-old female infant who was admitted to an intensive care unit with sudden infant death syndrome (SIDS). E. dermatitidiswas repeatedly isolated from blood cultures (on the 28th and 32nd day of hospitalization) of the patient, who died on the 44th day of hospitalization. The fungus was identified by its morphological characteristics and DNA sequencing of both the D1/D2 domain and the ITS region of rDNA. To our knowledge, this is the first reported case of E. dermatitidis fungemia in Korea.
DNA, Ribosomal ; Exophiala ; Female ; Fungemia ; Fungi ; Hospitalization ; Humans ; Infant ; Intensive Care Units ; Korea ; Sequence Analysis, DNA ; Sudden Infant Death

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Brodie's Abscess Caused by Salmonella enteritica serovar Senftenberg in a Healthy Child.

Nam Hee RYOO ; Jung Sook HA ; Kwang Soon SONG

Korean Journal of Clinical Microbiology.2010;13(3):132-134. doi:10.5145/KJCM.2010.13.3.132

Salmonella enteritica serovar Senftenberg is a rare pathogen in osteomyelitis, and is not usually encountered in healthy individuals. Here we report radiological and microbiological findings of a case of Brodie's abscess caused by S. enteritica serovar Senftenberg in the left tibia of an otherwise healthy child.
Abscess ; Child ; Humans ; Osteomyelitis ; Salmonella ; Tibia

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Aberrant Forms of Escherichia coli in Urine Culture.

Youngeun MA ; Jang Ho LEE ; Seung Tae LEE ; Chang Seok KI ; Nam Yong LEE

Korean Journal of Clinical Microbiology.2010;13(3):128-131. doi:10.5145/KJCM.2010.13.3.128

Bacterial morphology can be altered by various factors, including antibiotics. Unusually shaped, large, swollen organisms were observed in a urine culture obtained from a patient who had no history of antibiotic therapy. The organism was identified as Escherichia coli by the Vitek 2 system and by DNA sequencing of 16S rRNA and gyrB. The patient had no symptoms except fever, which subsided without medication. Microbiology laboratories should be aware of the potential appearance of such bacilli to avoid confusion with fungi and other naturally occurring filamentous organisms.
Anti-Bacterial Agents ; Atypical Bacterial Forms ; Escherichia ; Escherichia coli ; Fever ; Fungi ; Humans ; Sequence Analysis, DNA

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Two Cases of Clostridium citroniae Bacteremia in Cancer Patients.

Yangsoon LEE ; Eun Mi KOH ; Myungsook KIM ; Dongeun YONG ; Seok Hoon JEONG ; Kyungwon LEE ; Yunsop CHONG

Korean Journal of Clinical Microbiology.2010;13(3):125-127. doi:10.5145/KJCM.2010.13.3.125

Clostridium citroniae is a novel species reclassified from C. clostridioforme. Clostridium species are obligate anaerobes and spore-forming gram-positive rods. However, C. citroniae stains gram negative and does not consistently produce spores, making it difficult to identify. We isolated C. citroniae from the blood and peritoneal fluid of one patient, and from the blood of another patient, both of whom were undergoing cancer chemotherapy.
Ascitic Fluid ; Bacteremia ; Clostridium ; Coloring Agents ; Gram-Positive Rods ; Humans ; Spores

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Importance of Suspicion for the Identification of Mycoplasma in Wound Culture: A Case Report.

Sang Mee HWANG ; In Seon YOON ; Sei Ick JOO ; Jongyoun YI ; Eui Chong KIM

Korean Journal of Clinical Microbiology.2010;13(3):121-124. doi:10.5145/KJCM.2010.13.3.121

Genital mycoplasmas are rare in extraintestinal specimens, but can cause disseminated infections in immunocompromised patients and wound infections after surgery or injury. We report two cases of Myoplasma hominis wound infections after lung lobectomy and kidney transplantation, and a case of M. salivarium wound infection after aortic graft replacement. Mycoplasmas grew in aerobic and anaerobic cultures as tiny colonies but were not observed by gram- or acid fast stain and were confirmed by MYCOFAST EvolutioN 2 kit or 16S rRNA sequencing. These cases indicated that mycoplasmas were probably underestimated in wound infections because they were not in suspicion. We suggest that Mycoplasma should be suspected when microorganisms are not readily observable in Gram stains but can be cultured.
Coloring Agents ; Immunocompromised Host ; Kidney Transplantation ; Lung ; Mycoplasma ; Mycoplasma hominis ; Mycoplasma salivarium ; Transplants ; Wound Infection

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Comparison of ATB FUNGUS 2 and VITEK-2 Antifungal Susceptibility (AST-YS01) Tests for Candida Species Isolated from Blood Culture.

Soon Deok PARK ; Young UH ; In Ho JANG ; Kap Jun YOON ; Jong Hee SHIN

Korean Journal of Clinical Microbiology.2010;13(3):114-120. doi:10.5145/KJCM.2010.13.3.114

BACKGROUND: The VITEK-2 yeast susceptibility test (AST-YS01; bioMerieux, Hazelwood, MO, USA) has recently been introduced as a fully automated, commercial antifungal susceptibility test system that determines MIC endpoints spectrophotometrically, thereby eliminating subjective errors. We compared the ATB FUNGUS 2 (bioMerieux) and VITEK-2 (AST-YS01) systems to the CLSI M27 method for susceptibility testing of Candida isolates. METHODS: We tested 59 Candida species that were isolated from blood cultures at Wonju Christian Hospital between September 2008 and August 2009. We compared MIC results for amphotericin B, flucytosine, fluconazole and voriconazole using the ATB FUNGUS 2 and VITEK-2 (AST-YS01) tests to those obtained by the CLSI M27 broth microdilution method. RESULTS: Within two-fold dilutions of MICs, the agreement of the ATB FUNGUS 2 and VITEK-2 (AST-YS01) tests with the CLSI method according to antifungal agents were: amphotericin B, 100% vs. 100% flucytosine, 100% vs. 100% fluconazole, 83.6% vs. 98.3% and voriconazole, 83.6% vs. 96.7%, respectively. The categorical discrepancies for fluconazole and voriconazole were 20.4% and 18.6% for ATB FUNGUS 2, and 6.8% and 0% for VITEK-2 (ASTYS01). There were no major errors for fluconazole and voriconazole in either ATB FUNGUS 2 or VITEK-2 (AST-YS01) tests. CONCLUSION: The VITEK-2 system (AST-YS01) appears to be rapid and highly correlative with the CLSI method, suggesting that it is effective for antifungal susceptibility testing for Candida species in clinical settings.
Amphotericin B ; Antifungal Agents ; Candida ; Fluconazole ; Flucytosine ; Fungi ; Pyrimidines ; Triazoles ; Yeasts

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Comparison of Rapid Antigen Test and Real-Time Reverse Transcriptase PCR for Diagnosing Novel Swine Influenza A (H1N1).

Aerin KWON ; Jae Seok KIM ; Han Sung KIM ; Wonkeun SONG ; Ji Young PARK ; Hyoun Chan CHO ; Kyu Man LEE

Korean Journal of Clinical Microbiology.2010;13(3):109-113. doi:10.5145/KJCM.2010.13.3.109

BACKGROUND: Novel swine influenza (H1N1) was first identified in Mexico in April 2009. Because of its high infectivity and worldwide distribution, a rapid and efficient screening test is necessary. Here we evaluated the usefulness of a rapid antigen test currently in use, compared to real-time RT-PCR (rRT-PCR) as a screening test for detection of novel swine influenza (H1N1). METHODS: A total of 1,228 patients who visited Hallym University Kangdong Sacred Heart Hospital with influenza-like illness between 14 August 2009 and 30 September 2009, and were tested by both rapid antigen and rRT-PCR tests, were enrolled in this study. RESULTS: Sensitivity, specificity, predictive value of a positive test, and predictive value of a negative test for the rapid antigen test were 30.5%, 99.2%, 86.4% and 90.1%, respectively. Fifty-one (4.2%) patients were positive for both rapid antigen test and rRT-PCR, and 1,053 (85.7%) were negative for both rapid antigen test and rRT-PCR. A total of 124 (10.1%) patients showed a discrepancy between the two tests. Among them, 116 (9.4%) were only positive for rRT-PCR and 8 (0.7%) were only positive for the rapid antigen test. The latter 8 patients all showed negative H1/M2 results in rRT-PCR. There were significant differences in detection rates of the rapid antigen test between different H1 Ct (threshold cycle) interval groups and for different age groups (P<0.05). CONCLUSION: Although the rapid antigen test is easy to perform and provides fast results, its limits as a screening test for detection of novel swine influenza (H1N1) due to its low sensitivity compared to rRT-PCR need to be considered in practical situations.
Heart ; Humans ; Influenza, Human ; Mass Screening ; Mexico ; Real-Time Polymerase Chain Reaction ; Reverse Transcriptase Polymerase Chain Reaction ; RNA-Directed DNA Polymerase ; Sensitivity and Specificity ; Swine

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Outbreak of Swine-Origin Influenza A (H1N1); Experience of a Regional Center in Seoul during a Month, August-September 2009.

Soo Jin YOO ; Choong Hee NOH ; Hyeon Mi YOO ; Won Chang SHIN ; Soo Jeon CHOI ; Baek Nam KIM ; Chang Keun KIM ; Myoung Jae CHEY ; Kyunam KIM ; Sang Lae LEE ; Eun Young KUAK ; Bo Moon SHIN

Korean Journal of Clinical Microbiology.2010;13(3):103-108. doi:10.5145/KJCM.2010.13.3.103

BACKGROUND: The aim of this study is to clarify the epidemiology of swine-origin influenza A (H1N1) virus 2009 (S-OIV) during the first month of outbreak at one of influenza clinic in Seoul, Korea. METHODS: We documented the epidemiologic and clinical features of S-OIV-confirmed cases who visited a university hospital in Northeastern Seoul between August 21 and September 20, 2009. Nasopharyngeal swab of patients with acute febrile respiratory illnesses were evaluated with rapid influenza antigen tests and multiplex RT-PCR for S-OIV and seasonal influenza A. RESULTS: A total of 5,322 patients with acute febrile respiratory illnesses were identified at our influenza clinic for the study period. S-OIV was confirmed in 309 patients by RT-PCR. The patients ranged from 2 months to 61 years of age and 189 patients (61.2%) were teenagers. Eighty-one patients had known contact with S-OIV-confirmed patients in schools (N=61), households (N=15), and healthcare facilities (N=3). Frequent symptoms were fever (94.5%), cough (73.1%), sore throat (52.1%), and rhinorrhea (50.5%). Gastrointestinal symptoms were also present in 10 patients (4.9%). Ten patients (4.9%) required hospitalizations. Seventy patients (22.7%) could not take oseltamivir at the first visits, however, all of them recovered without complication. Rapid antigen tests showed the sensitivity of 44.4% (130/294). Patients with positive antigen tests, compared with negative antigen tests, showed higher frequencies of rhinorrhea (60.8% vs 43.3%, P=0.004) and stuffy nose (33.8% vs 20.1%, P=0.012). CONCLUSION: S-OIV infections spread predominately in school-aged children during the early accelerating phase of the outbreak. Rapid influenza antigen tests were correlated with nasal discharge and obstruction.
Adolescent ; Child ; Cough ; Delivery of Health Care ; Family Characteristics ; Fever ; Hospitalization ; Humans ; Influenza A virus ; Influenza, Human ; Korea ; Nose ; Oseltamivir ; Pharyngitis ; Seasons ; Viruses

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