Tracheobronchopathia osteochondroplastica (TO) is a rare benign disease of unknown etiology characterized by accumulation of calcium phosphate in the submucosa of large airways and benign proliferation of bone and cartilage resulting in nodular formation. We report a case of tracheobronchopathia osteochondroplastica diagnosed by Endobronchial ultrasonography in a 56-year-old man. Chest Computed Tomography revealed thickening of tracheal and bronchial wall, and multiple nodules through whole trachea. Endobronchial ultrasonography showed numerous submucosal nodules with hetero-echogenecity in the third and fourth layers. Histopathological examination revealed nonspecific bronchitis with squamous metaplasia and metaplastic ossification. We confirmed tracheobronchopathia osteochondroplastica. The patient's symptoms were successfully treated with antibiotics and oxygen supplyment. endobronchial ultrasonography can helpful diagnosis in tracheobronchopathia osteochondroplastica.
Anti-Bacterial Agents ; Bronchitis ; Calcium ; Calcium Phosphates ; Cartilage ; Humans ; Metaplasia ; Middle Aged ; Osteochondrodysplasias ; Oxygen ; Thorax ; Trachea ; Tracheal Diseases

BACKGROUND: CLSI provides a guideline only for a agar dilution method of testing clarithromycin susceptibility for Helicobacter pylori. This study was to evaluate a disk diffusion method for clarithromycin and amoxicillin. METHODS: One hundred and forty clinical isolates of H. pylori isolated from May 2005 to May 2007 were tested by the CLSI agar dilution method and a disk diffusion method using 2microgram (2CLR) and 15microgram (15CLR) clarithromycin disks and 2microgram (2AMX) and 10microgram (10AMX) amoxicillin disks. The interpretation criteria used for the disk diffusion method were established by linear regression and error rate-bounded method for disk diffusion zone of inhibition (DDZ) compared to MIC. RESULTS: Resistance and intermediate rates to clarithromycin were 21.4% and 1.4%, respectively. A number of isolates with MIC 0.5, 1, and 2 (microgram/mL) to amoxicillin were 7, 2, and 1, respectively. For 2CLR and 15CLR, the coefficients of determination (R2) between MIC and DDZ were 0.931 and 0.923 (P< 0.001), respectively, and the criteria for resistance/ susceptibility were 12/28 mm for 2CLR and 23/39 mm for 15CLR. For 2AMX and 10AMX, the R2 between MIC and DDZ were 0.478 and 0.421 (P< 0.001), respectively, and the criteria for resistance with breakpoint of 2microgram/mL were 21 mm for 2AMX and 32 mm for 10AMX. All isolates had DDZ<60 mm with 2CLR and 2AMX, but 61.4% and 75.7% of the isolates had DDZ<60 mm with 15CLR and 10AMX, respectively. CONCLUSION: Excellent correlation and agreement between MIC and DDZ were found for clarithromycin and amoxicillin. With 2microgram disks, the susceptibility breakpoints were 28 mm or less; thus, two disks could be tested in one plate.
Agar ; Amoxicillin ; Clarithromycin ; Diffusion ; Helicobacter ; Helicobacter pylori ; Linear Models

BACKGROUND: Clarithromycin resistance in Helicobacter pylori is a major cause of eradication therapy failure. The objective of this study was to determine the frequency and type of mutations in the 23S rRNA gene in Korea, which are associated with clarithromycin resistance. METHODS: From January 2008 to March 2008, 353 gastric biopsy specimens were collected from five university hospitals in Seoul and Kyunggido. H. pylori infection was defined as showing a positive result in at least one of the following three tests: a microaerophilic culture, a CLO test, and a Giemsa/silver stain. The frequencies of A2143G, A2142G, and the wild type of 23S rRNA and the presence of H. pylori were determined by Seeplex ClaR-H. pylori PCR (Seegene Inc., Seoul, Korea). Twenty-nine culture isolates were tested for susceptibility to clarithromycin by E-test (AB Biodisk, Solna, Sweden) or the CLSI (Clinical and Laboratory Standards Institute) disk diffusion test. RESULTS: From 176 H. pylori PCR-positive specimens, 23S rRNA gene mutations were detected in 38 isolates (21.6%), including 27 isolates of A2143G and 11 isolates of A2142G. Total mutation rates varied from 15.8% to 31.3% with the frequency of A2143G mutation alone varying from 8.5% to 25.0% among the five hospitals studied. There were 10 clarithromycin-resistant isolates found by susceptibility test and they were all positive for A2143G mutation. But, 3 of the 19 susceptible isolates were also positive for either A2143G or A2142G mutation. CONCLUSION: In Korea, the overall frequency of clarithromycin-resistant H. pylori was 21.6%; however, the type and frequency of the 23S rRNA mutations varied from hospital to hospital.
Biopsy ; Clarithromycin ; Diffusion ; Genes, rRNA ; Helicobacter ; Helicobacter pylori ; Hospitals, University ; Korea ; Mutation Rate ; Point Mutation ; Polymerase Chain Reaction

BACKGROUND: The aim of this study is to determine the nationwide prevalence of Ambler class A extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae and to characterize genotypes of ESBLs. METHODS: During the period of February through July, 2003, E.coli and K.pneumoniae isolates were collected from 12 hospitals in Korea. Antimicrobial susceptibilities were tested by disk diffusion method, and ESBL-production was determined by the double-disk synergy test. MICs of beta-lactam antibiotics were tested by agar dilution method. Searches for bla TEM, bla SHV, bla CTX-M, bla PER-1, bla VEB, bla IBC, bla GES and bla TLA genes were performed by PCR amplification, and the genotypes of ESBLs were determined by direct nucleotide sequence analysis of amplified products. RESULTS: Resistance rates of E.coli (n=246) and K.pneumoniae (n=239) isolates to ceftazidime were 8.5% and 20.1%, respectively. Most prevalent Ambler class A ESBL genotypes in E.coli isolates were bla CTX-M-15 (n=4) and bla CTX-M-3 (n=3), and each of bla CTX-M-14, bla SHV-12, and bla TEM-52 gene was also found in one isolate. Most prevalent ESBL genotypes in K.pneumoniae were bla SHV-12 (n=30) and bla CTX-M-3 (n=13), and bla CTX-M-14 (n=5). bla SHV-2a (n=3), bla SHV-5 (n=2), bla TEM-52 (n=1), bla GES-3 (n=2) genes were also found. CONCLUSION: CTX-M-type ESBL-producing E.coli and K.pneumoniae isolates are spreading, and a GES-type ESBL has emerged in Korea.
Agar ; Anti-Bacterial Agents ; Base Sequence ; beta-Lactamases ; Ceftazidime ; Diffusion ; Escherichia coli* ; Escherichia* ; Genotype ; Klebsiella pneumoniae* ; Klebsiella* ; Korea* ; Polymerase Chain Reaction ; Prevalence*

PURPOSE: This study was performed to characterize clinical features of benign convulsions with gastroenteritis (CwG) in infants. METHODS: We reviewed clinical features of 67 episodes in 64 patients with afebrile seizure accompanied gastroenteritis admitted to Dept. of Pediatrics Bundang CHA hospital from January 2001 to June 2004. Patients with meningitis, encephalitis/encephalopathy or apparent history of epilepsy were excluded. RESULTS: There were 32 boys and 35 girls. The age of onset ranged from 1 to 42 months (18.5+/-6.1 months). The number of children admitted to the hospital with acute gastroenteritis was 2, 887 in the same period. The percentage of patients with CwG was 2.3. Seizure type was exclusively generalized tonic or tonic-clonic seizure. The average number of seizures during a single episode was 3.1 (range, 1-13). Two or more seizures occurred in 53 (79.1%) of the 67 episodes. Antiepileptic drugs were administered for 42 episodes. Seizure did not cease after the administration of one kind of antiepileptic drug in 23 episodes (54.7%). The seizures were rather refractory to initial antiepileptic treatment. There were no abnormalities in serum biochemistry test including glucose and electrolytes. Cerebrospinal fluid was normal in all 54 episodes. Stool cultures were negative in 49 episodes. Rotavirus was positive in stools in 51 (82.3%) of 62 episodes. Norovirus was positive in stools in 2 episodes and astrovirus in 1 of 18 episodes. CT and/or MRI were performed in 15 cases and demonstrated no neuroradiologic abnormalities. Of 73 Interictal EEG, initial 24 cases showed occasional spike or sharp wave discharges from the mid-line area during stage I-II sleep, which were apparently differentiated from vertex sharp transient or K-complexes. The mean follow-up period was 5.7 months (1-36 months). Three patients experienced a recurrence of CwG, but all patients exhibited normal psychomotor development at the last follow-up. CONCLUSION: Afebrile infantile convulsions with gastroenteritis are brief generalized seizure in cluster with normal laboratory findings and good prognosis. Therefore CwG is likely to be categorized as situation-related seizure of special syndrome. Recognition of this entity should lead to assurance of the parents and long-term anticonvulsant therapy is not usually warranted.
Age of Onset ; Anticonvulsants ; Biochemistry ; Cerebrospinal Fluid ; Child ; Electroencephalography ; Electrolytes ; Epilepsy ; Female ; Follow-Up Studies ; Gastroenteritis* ; Glucose ; Humans ; Infant ; Magnetic Resonance Imaging ; Meningitis ; Norovirus ; Parents ; Pediatrics ; Prognosis ; Recurrence ; Rotavirus ; Seizures*

PURPOSE: Rotavirus is the main cause of infantile diarrheal disease worldwide, especially in patients 3-24 months of age. Infants younger than 3 months of age are relatively protected by transplacental antibody. So the purpose of this study is to evaluate the clinical features and severity of neonatal rotaviral gastroenteritis less than 1 month of age. METHODS: A retrospective chart review was established of 62 neonates less than 1 month of age and with a diagnosis of rotaviral gastroenteritis who had been admitted to Pochon CHA University between June 2002 through July 2004. The rotavirus was examined by stool latex agglutination. RESULTS: During 2 years, the total number of admitted patients for rotaviral gastroenteritis was 688 and among these, less than 1 month of age accounted for 9% (62). The occurrence was generally even distribution from January to July (7.14+/-1.0) but since then decreased (2.4+/-1.8). The most common chief complaint was mild fever (46%) when admitted which subsided within 1 hospital day in most patients. 4 patients had seizure and cyanosis with no typical symptoms of rotaviral gastroenteritis. During admission, all the patients had diarrhea. 17% of the patients had leukocytosis and positive C-reactive protein. In one patient, stool occult blood test was positive but there was no necrotizing gastroenteritis evidence. The mean period of hospital day was 5.8+/-2.5 and breast-milk feeding was 62.9%. CONCLUSION: Neonatal rotaviral gastroenteritis is not a rare disease. Most patients have fever and diarrhea and improve through conservative therapy but a few patients may have severe complications so we must be more cautious about the hygiene for prevention.
Agglutination ; C-Reactive Protein ; Cyanosis ; Diagnosis ; Diarrhea ; Fever ; Gastroenteritis* ; Humans ; Hygiene ; Infant ; Infant, Newborn* ; Latex ; Leukocytosis ; Occult Blood ; Rare Diseases ; Retrospective Studies ; Rotavirus ; Seizures

BACKGROUND: Essential hyperhidrosis is a pathologic condition caused by excessive secretion of the eccrine sweat glands. This is an embarrassing condition, which severely reduces the quality of life and may result in psychological disturbance. Our purpose was to determine the therapeutic efficacy of oral glycopyrrolate in term of its strength, safety, and side effects. METHODS: Oral glycopyrrolate was given to 104 patients, 53 men and 51 women with a mean age of 24 years. Patients controlled the dosage of glycopyrrolate for a week. Attention was focused on patient satisfaction, onset time, duration, degree of reducing perspiration and side effects. RESULTS: Ninety eight of 104 patients (94%) were satisfied with their improved condition. The most common maximum dose/day was 2 mg. The overall mean onset time was 2.3 hours and the duration of the effect was 7.4 hours. Dry mouth occurred in 40 patients. Sixty eight of patients (65%) experienced reduced excessive sweating caused by oral glycopyrrolate. CONCLUSIONS: The administration of oral glycopyrrolate is a safe and effective method of treating essential hyperhidrosis, and appears to be an acceptable therapeutic option in any form of hyperhidrosis.
Female ; Glycopyrrolate* ; Humans ; Hyperhidrosis* ; Male ; Mouth ; Patient Satisfaction ; Quality of Life ; Sweat ; Sweat Glands ; Sweating

No abstract available.
Animals ; Apoptosis* ; Cardiomyopathies* ; Doxorubicin* ; Rats* ; Transducers*

BACKGROUND: There has been significant progress in the identification of tumor associated antigens. Among the tumor associated antigens, MAGE (melanoma antigen), BAGE, GAGE, PRAME, NY-ESO were named as cancer/testis specific antigens since they are only expressed in the testis or cancer cells. Because of their relative specificity, they have been considered as the appropriate targets for the specific immunotherapy, or the early diagnosis of several cancers. In bronchogenic cancer, these antigens would be useful as a promising candidate in the screening test or immunotherapy. This study was to investigate the expression of MAGE and GAGE genes in the bronchogenic cancer tissues obtained by bronchoscopy. METHODS: In five normal bronchial and 26 cancer tissues obtained by bronchoscopic biopsy from 26 bronchogenic cancer patients, total cellular mRNA was extracted. Then RT PCR was run in 35 cycles, with two different kinds of primers designed to detect the several subtypes of MAGE DNA simultaneously and the similar process to detect GAGE DNA was also done. Concurrently, DNA sequencing of the isolates was done in portion to prove the isolates are cloned MAGE and GAGE DNA. With probes confirmed by DNA sequencing, the isolates were reevaluated by Southern blotting. Then the expression of MAGE or GAGE in the bronchogenic cancer tissues was evaluated by the tissue types and clinical staging. RESULTS: In the five controls, MAGE or GAGE was not detected in any specimen and beta actin was not expressed in 4 cases, suggesting the specimen might be too small to detect beta actin by 35 cycles of PCR. In the 26 cancer tissues, the expression rate of MAGE and GAGE was 42.3% (11/26) and 42.3% (11/26) respectively and MAGE or GAGE were expressed in 17 cases (65.3%). Neither clinical staging nor tissue types were associated with the expression of MAGE or GAGE. Beta actin was not detected in 11 cases of cancer specimen, but MAGE or GAGE were expressed in 10 cases of them. CONCLUSION: Using these primers in detection of MAGE or GAGE genes in the bronchoscopicbiopsy tissues seems to be effective or complimentary method in screening of bronchogenic cancer patients, who would be the candidate for the possible immunotherapy.
Actins ; Biopsy ; Blotting, Southern ; Bronchoscopy* ; Clone Cells ; DNA ; Early Diagnosis ; Humans ; Immunotherapy ; Mass Screening ; Polymerase Chain Reaction ; RNA, Messenger ; Sensitivity and Specificity ; Sequence Analysis, DNA ; Testis

Peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD) remains a major problem. Peritonitis due to Cryptococcus neoformans is an unusual complication. A 68-year-old woman on prednisolone for Behcets disease and adrenal insufficiency was admitted with chronic renal failure and CAPD was initiated. During her stay in hospital, she was treated with multiple antibiotics for urinary tract infection and CAPD peritonitis with methicillin resistant Staphylococcus aureus (MRSA). She was deteriorated insidiously and C. neoformans was cultured in the dialysate but not in the blood, urine and stool. After three days, she died. We reviewed 385 organisms isolated from 1,325 peritoneal dialysate specimens between 1990 and 2002. Staphylococcus aureus was most frequently isolated (22.6%). Fungus comprises 10.1% of the isolated organisms.
Adrenal Insufficiency ; Aged ; Anti-Bacterial Agents ; Cryptococcus neoformans ; Female ; Fungi ; Humans ; Kidney Failure, Chronic ; Methicillin Resistance ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Prednisolone ; Staphylococcus aureus ; Urinary Tract Infections