To determine the characteristics of seroprevalence of herpes simplex virus type 2 (HSV-2) infection among Korean people, a cross-sectional study was conducted on three groups in 2004. The three groups consisted of the general public who visited public health centers, commercial sex workers (CSWs), and human immunodeficiency virus (HIV)-infected persons. Among the general public, HSV-2 seroprevalence rates for age under the 20s, in the 20s, 30s, 40s and the above 22.6%, 32.7% and 32.3%, respectively, which showed rapid increase of the rate in the 30s (p<0.0001). In case of the above of 19 yr old, women (28.0%) was higher than men (21.7%) (p<0.0001). The rate of CSWs (81.6%) was about 10 times higher than that of general women. In case of HIV-infected men (47.6%), the figure was about 2-3 times higher than that of general men. The low rate in the teens and the 20s proved that it is essential to develop sexually transmitted infections (STIs) prevention programs of education and publicity for them as a precaution measure. This study is the first major study of its kind on HSV-2 and would provide basic data for prevention of STIs including information about target groups subject to vaccination program.
Adult ; Age Factors ; Aged ; Antibodies, Viral/*blood ; Female ; HIV Infections/complications ; Herpes Genitalis ; Herpesvirus 2, Human/*immunology ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Seroepidemiologic Studies

PURPOSE: The aims of this study were to analyze the clinical characteristics of children with Kikuchi's disease(KD) at a medical center and to investigate the etiologic role of human herpesvirus 8(HHV 8) or Epstein-Barr virus(EBV) in children with KD. METHODS: Twenty six children who were diagnosed as KD between Jan. 1998 and Dec. 2005 were included. Medical records were reviewed on the clinical characteristics of children with KD. Follow up data were collected by chart review and telephone contact. Polymerase chain reaction(PCR) was performed in order to detect HHV 8 DNA, and in situ hybridization(ISH) was perfomed in order to detect EBV RNA from 20 lymph node tissues. RESULTS: There were 15 girls and 11 boys with a mean age of 13 years. Posterior cervical lymph nodes were involved in 72 percent(18/25) of the patients. Extracervical lymphadenopathy was associated in one patient. Fever was an associated symptom in 31 percent(8/26) of the patients. Leukopenia was observed in six (46 percent) patients. The cervical lymphadenopathy usually resolved spontaneously within 6 months. Only one patient had a recurrence of lymphadenopathy with fever during follow-up. No children with KD in our series developed systemic lupus erythematosus. HHV 8 DNA was not amplified by nested PCR in any of the cases, and all cases were negative for EBV RNA by ISH. CONCLUSION: KD should be differentiated as a cause of cervical lymphadenopathy in children. HHV 8 and EBV may not play major causative roles in KD in children.
Child* ; DNA ; Female ; Fever ; Follow-Up Studies ; Herpesvirus 4, Human* ; Histiocytic Necrotizing Lymphadenitis* ; Humans ; Humans* ; Leukopenia ; Lupus Erythematosus, Systemic ; Lymph Nodes ; Lymphatic Diseases ; Medical Records ; Polymerase Chain Reaction ; Recurrence ; RNA ; Telephone

Human embryonic stem (ES) cells can be induced to differentiate into hematopoietic precursor cells via two methods: the formation of embryoid bodies (EBs) and co-culture with mouse bone marrow (BM) stromal cells. In this study, the above two methods have been combined by co-culture of human ES-cell-derived EBs with human BM stromal cells. The efficacy of this method was compared with that using EB formation alone. The undifferentiated human ES cell line SNUhES3 was allowed to form EBs for two days, then EBs were induced to differentiate in the presence of a different serum concentration (EB and EB/high FBS group), or co- cultured with human BM stromal cells (EB/BM co-culture group). Flow cytometry and hematopoietic colony-forming assays were used to assess hematopoietic differentiation in the three groups. While no significant increase of CD34+/CD45- or CD34+/CD38- cells was noted in the three groups on days 3 and 5, the percentage of CD34+/CD45- cells and CD34+/ CD38- cells was significantly higher in the EB/BM co-culture group than in the EB and EB/high FBS groups on day 10. The number of colony-forming cells (CFCs) was increased in the EB/BM co-culture group on days 7 and 10, implying a possible role for human BM stromal cells in supporting hematopoietic differentiation from human ES cell-derived EBs. These results demonstrate that co-culture of human ES-cell-derived EBs with human BM stromal cells might lead to more efficient hematopoietic differentiation from human ES cells cultured alone. Further study is warranted to evaluate the underlying mechanism.
Stromal Cells/physiology ; Stem Cells/*cytology ; Humans ; Hematopoietic Stem Cells/*cytology ; Embryo/*cytology ; Coculture Techniques ; Cells, Cultured ; *Cell Differentiation ; Bone Marrow Cells/*cytology ; Antigens, CD45/analysis ; Antigens, CD38/analysis ; Antigens, CD34/analysis

BACKGROUND: In spite of active HIV/AIDS control and managements, UNAIDS estimate that 40 million people were living worldwide with HIV at the end of 2001. In Korea, The member of HIV- infected adults are continuously growing. For improvement of HIV screening and prevention, we analyzed over times the relationship between the changes in initial CD4+ T cell counts of newly HIV- diagnosed adults, sex, and exposure route. METHODS: We selected 1011 newly HIV-diagnosed adults whose initial CD4+ T cell count was determined within 6 months of HIV diagnosis between 1990 and June, 2002. Based on CD4+ T cell counts, the selected people were grouped into 4 as follows: <200 cells/mm3, 200-349 cells/mm3, 350-699 cells/mm3, and >700 cells/mm3. The relationship between initial CD4+ T cell counts, age, sex, and HIV risk category were studied by regression statistic methods. RESULTS: The median initial CD4+ T cell counts decreased over times (P<0.001). In each major group, over 50% of initial CD4+ T cell counts were below 350 cells/mm3. For homosexually infected adults, the median age did not statistically increase (P=0.062). However, in heterosexually infected adults, the median age increased throughout the time period examined (P<0.001) with an exception of female group (P=0.427). The multi-regression analyses revealed that older age (P<0.001) and male sex (P<0.001) were independently associated with lower initial CD4+ T cell counts, but not exposure group (P=0.483). For each year cohort of newly diagnosed adults, the median initial CD4+ T cell counts in subsequent years decreased until 1998 and then increased thereafter. CONCLUSION: These results show that a large proportion of HIV-infected adults are being diagnosed late in the course of HIV infection, particularly heterosexually infected male group. Therefore, we should continuously enforce screening, prevention and prompt diagnosis of high risk groups.
Adult ; Cell Count* ; Cohort Studies ; Diagnosis ; Female ; HIV ; HIV Infections ; Homosexuality ; Humans ; Korea ; Male ; Mass Screening

BACKGROUND: In spite of active HIV/AIDS control and managements, UNAIDS estimate that 40 million people were living worldwide with HIV at the end of 2001. In Korea, The member of HIV- infected adults are continuously growing. For improvement of HIV screening and prevention, we analyzed over times the relationship between the changes in initial CD4+ T cell counts of newly HIV- diagnosed adults, sex, and exposure route. METHODS: We selected 1011 newly HIV-diagnosed adults whose initial CD4+ T cell count was determined within 6 months of HIV diagnosis between 1990 and June, 2002. Based on CD4+ T cell counts, the selected people were grouped into 4 as follows: <200 cells/mm3, 200-349 cells/mm3, 350-699 cells/mm3, and >700 cells/mm3. The relationship between initial CD4+ T cell counts, age, sex, and HIV risk category were studied by regression statistic methods. RESULTS: The median initial CD4+ T cell counts decreased over times (P<0.001). In each major group, over 50% of initial CD4+ T cell counts were below 350 cells/mm3. For homosexually infected adults, the median age did not statistically increase (P=0.062). However, in heterosexually infected adults, the median age increased throughout the time period examined (P<0.001) with an exception of female group (P=0.427). The multi-regression analyses revealed that older age (P<0.001) and male sex (P<0.001) were independently associated with lower initial CD4+ T cell counts, but not exposure group (P=0.483). For each year cohort of newly diagnosed adults, the median initial CD4+ T cell counts in subsequent years decreased until 1998 and then increased thereafter. CONCLUSION: These results show that a large proportion of HIV-infected adults are being diagnosed late in the course of HIV infection, particularly heterosexually infected male group. Therefore, we should continuously enforce screening, prevention and prompt diagnosis of high risk groups.
Adult ; Cell Count* ; Cohort Studies ; Diagnosis ; Female ; HIV ; HIV Infections ; Homosexuality ; Humans ; Korea ; Male ; Mass Screening

A clinical isolate of Klebsiella pneumoniae K7746 produced the extended-spectrum beta-lactamase (ESBL) SHV-12. A 6.6 kb BamHI fragment containing the blaSHV-12 gene of K7746 strain was cloned into pCRScriptCAM vector resulting in the recombinant plasmid p7746-C1. The restriction map of 3.6 kb inserted DNA and sequences immediately surrounding blaSHV-12 of p7746-C1 were homologous to plasmid pMPA2a carrying blaSHV-2a. In addition, both blaSHV-12 and blaSHV-2a were expressed from a common hybrid promoter made of the -35 region derived from the left inverted repeat of IS26 and the -10 region from the blaSHV promoter itself. The results indicate that blaSHV-12 and blaSHV-2a may have evolved from a common ancestor in the sequential order of blaSHV-2a first, followed by blaSHV-12. Furthermore, by the PCR mapping method using primers corresponding to the IS26 and blaSHV, the association between IS26 and blaSHV was studied in 12 clinical isolates carrying blaSHV-2a, 27 clinical isolates carrying blaSHV-12, and 5 reference strains carrying blaSHV-1 to blaSHV-5. All 39 strains carrying blaSHV-2a or blaSHV-12 were positive by the PCR, providing confirmative evidence that IS26 has been involved in the evolution and dissemination of blaSHV-2a and blaSHV-12. But 5 reference strains carrying blaSHV-1 to blaSHV-5 were negative by the PCR. Therefore, we concluded that the molecular evolutionary pathway of blaSHV-2a and blaSHV-12 may be different from that of other blaSHV-ESBL, e.g., blaSHV-2, blaSHV-3, blaSHV-4, and blaSHV-5.
beta-Lactamases ; Clone Cells ; DNA ; Klebsiella pneumoniae ; Plasmids ; Polymerase Chain Reaction

One hundred and thirty trimethoprim-resistant R plasmids derived from of Escherichia coli isolated from clinical specimens and feces of healthy collegians were examined for incompatibility, EcoRI endonuclease restriction fragment pattern, and Southern hybridization with DHFR I, II, III, V, and VII probe. 1. Most trimethoprim-resistant R plasmids were resistant to ampicillin, tetracycline, chloramphenicol, gentamicin, and kanamycin, and showed multiple drug resistance and various antimicrobial resistance patterns. 2. Trimethoprim-resistant R plasmids ranged from 90 to 50 kilobase and 42.3% of R plasmids tested were classified to incompatibilty group Inc FI, Inc FII or Inc FIV, 3. Among 48 random selected R plasmids from various origin, 14 R plasmids (including 9 of 14 Inc FII plasmids and 3 of 14 Inc FI plasmids) hybridized with DHFR VII oligonucleotide probe but others did not respond to any of DHFR probes used. 4. Most R plasmids showed various EcoRI endonuclease fragments and different reaction sites by Southern hybridization. Six plasmids showed identical or nearly identical molecular weight, EcoRI endonuclease fragment patterns and different sites of Southern hybridization. But 2 Inc FII plasmids derived from urine and feces showed identical pattern. These findings, if confirmed by further studies, suggest that normal flora E. coli can act as reservoir of resistant genes and, consequently, as a factor in the dissemination of these genes among enteric pathogens and need to be examined further.
Ampicillin ; Chloramphenicol ; Deoxyribonuclease EcoRI ; Drug Resistance, Multiple ; Escherichia coli* ; Escherichia* ; Feces ; Gentamicins ; Immunodeficiency Virus, Feline ; Kanamycin ; Molecular Biology* ; Molecular Weight ; Plasmids ; R Factors ; Tetracycline ; Trimethoprim Resistance* ; Trimethoprim*

BACKGROUND: Detection of extended-spectrum beta-lactamase (ESBL) expression is difficult in ordinary clinical laboratories. The Etest has been introduced into clinical settings for the rapid identification of ESBL. The principle behind the Etest is to compare the minimal inhibitory concentration (MIC) of ceftazidime alone with the MIC of ceftazidime with clavulanic acid. The aim of this study was to evaluate the efficiency of the Etest for the detection of ESBL in Korea, where antimicrobial resistance rates are high. METHODS: The double disk synergy test and the Etest were performed simultaneously. The results of the clinical isolates were compared to those of strains producing TEM-1, TEM-2, and SHV-1 as negative controls. The results of the double disk synergy test and the E-test were confirmed by isoelectric focusing of beta-lactamase extracted from suspicious ESBL-producing strains. RESULTS: MIC determination using the standard agar dilution method according to the National Committee for Clinical Laboratory Standards revealed that a total of 48 strains were resistant or intermediate against one or more antibiotics of the third generation cephalosporins. These strains included five strains of E. coli, 14 of S. marcescens, seven of K. pneumoniae, 18 of Enterobacter spp., and four of Citrobacter spp. Sixteen (33%) of the strains, including five strains of E. coli, three of S. marcescens, five of K. pneumoniae, and three of Enterobacter spp. were ESBL- producing strains that were confirmed by double disk synergy test. Thirteen (81%) of the strains of ESBL- producing organisms were detected by Etest, but the remaining three strains (19%) were undetectable by Etest alone. CONCLUSION: The accuracy of Etest for the detection of ESBL was not high, but the efficiency of Etest as the primary screening method of a large number of clinical isolates was appreciable regarding efficiency and rapidity.
Agar ; Anti-Bacterial Agents ; beta-Lactamases* ; Ceftazidime ; Cephalosporins ; Citrobacter ; Clavulanic Acid ; Enterobacter ; Gram-Negative Bacteria ; Isoelectric Focusing ; Korea ; Mass Screening ; Pneumonia

BACKGROUND: There have been few studies about the kinds of species causing surgical site infections and their resistance pattern in Korea. An increase of extended-spectrum beta-lactamase (ESBL) producing strains is a worldwide problem. However, there is not enough data on the prevalence of ESBL-producing strains in Korea and the true extent of this problem seems to be under-recognized. METHODS: Minimal inhibitory concentrations of gram-negative bacilli isolated from surgical site infections were tested using the standard agar dilution method according to the National Committee for Clinical Laboratory Standards. To identify and characterize beta-lactamases, we performed conjugation test, isoelectric focusing, Southern hybridization, and polymerase chain reaction. RESULTS: A total of 54 strains of gram-negative enteric bacilli were identified:two strains of Acinetobacter spp., one of Citrobacter freundii, nine of Enterobacter cloacae, one of Enterobacter sakazakii, one of Escherichia coli, two of Klebsiella pneumoniae, one of Morganella morganii, one of Proteus vulgaris, 23 of Pseudomonas aeruginosa, four of Xanthomonas maltophila, and nine of Serratia marcescens. Three strains produced ESBL. CONCLUSION: Various species of gram-negative organisms isolated from surgical site infections showed complex antibiograms to various beta-lactams, even to the new generation of antibiotics. A large proportion of these strains showed conjugally transferable, plasmid-mediated, beta-lactam resistance. Some strains were ESBL-producing. This evidence suggests that there has been a molecular evolution of beta-lactamase genes to a great extent in Korea, possibly due to indiscriminate use of antibiotics.
Acinetobacter ; Agar ; Anti-Bacterial Agents ; beta-Lactam Resistance* ; beta-Lactamases ; beta-Lactams ; Citrobacter freundii ; Cronobacter sakazakii ; Drug Resistance ; Enterobacter cloacae ; Escherichia coli ; Evolution, Molecular ; Isoelectric Focusing ; Klebsiella pneumoniae ; Korea ; Microbial Sensitivity Tests ; Morganella morganii ; Polymerase Chain Reaction ; Prevalence ; Proteus vulgaris ; Pseudomonas aeruginosa ; Serratia marcescens ; Xanthomonas

BACKGROUND: Detection of extended-spectrum beta-lactamase (ESBL) expression is difficult in ordinary clinical laboratories. The Etest has been introduced into clinical settings for the rapid identification of ESBL. The principle behind the Etest is to compare the minimal inhibitory concentration (MIC) of ceftazidime alone with the MIC of ceftazidime with clavulanic acid. The aim of this study was to evaluate the efficiency of the Etest for the detection of ESBL in Korea, where antimicrobial resistance rates are high. METHODS: The double disk synergy test and the Etest were performed simultaneously. The results of the clinical isolates were compared to those of strains producing TEM-1, TEM-2, and SHV-1 as negative controls. The results of the double disk synergy test and the E-test were confirmed by isoelectric focusing of beta-lactamase extracted from suspicious ESBL-producing strains. RESULTS: MIC determination using the standard agar dilution method according to the National Committee for Clinical Laboratory Standards revealed that a total of 48 strains were resistant or intermediate against one or more antibiotics of the third generation cephalosporins. These strains included five strains of E. coli, 14 of S. marcescens, seven of K. pneumoniae, 18 of Enterobacter spp., and four of Citrobacter spp. Sixteen (33%) of the strains, including five strains of E. coli, three of S. marcescens, five of K. pneumoniae, and three of Enterobacter spp. were ESBL- producing strains that were confirmed by double disk synergy test. Thirteen (81%) of the strains of ESBL- producing organisms were detected by Etest, but the remaining three strains (19%) were undetectable by Etest alone. CONCLUSION: The accuracy of Etest for the detection of ESBL was not high, but the efficiency of Etest as the primary screening method of a large number of clinical isolates was appreciable regarding efficiency and rapidity.
Agar ; Anti-Bacterial Agents ; beta-Lactamases* ; Ceftazidime ; Cephalosporins ; Citrobacter ; Clavulanic Acid ; Enterobacter ; Gram-Negative Bacteria ; Isoelectric Focusing ; Korea ; Mass Screening ; Pneumonia