Background/Aims: Although the diarrheal disease caused by Campylobacter bacteria has been continuously increasing in Korea, there has been limited study on the clinical aspects of Campylobacter enteritis in adults in Korea. The purpose of this study was to analyze the clinical features and characteristics of adult patients with Campylobacter enteritis. Methods: This retrospective study included patients diagnosed with Campylobacter enterocolitis at Nowon Eulji University Hopsital between January 2016 and December 2017. Campylobacter enterocolitis was diagnosed through polymerase chain reaction of stools from patients with acute diarrhea. Results: Among 630 hospitalized patients with acute diarrhea, Campylobacter enterocolitis was diagnosed in 88 patients (14.0%). The mean age was 37.9±19.1 years. Campylobacter enterocolitis was most prevalent in the summer (52 patients, 59.1%). Patients exhibited more than 10 times of diarrhea in 36 (40.9%), high fever above 39℃ in 19 (21.59%), and abdominal pain above 5 points on the numeric rating scale in 23 (26.14%) cases. In abdominal CT scan, pancolitis was found in 58 patients (65.9%). Small intestine was involved in 37 patients (42.4%). Mean CRP was 10.14 mg/dL (range 0.72-32.27 mg/dL). The duration of diarrhea after antibiotics treatment was 2.34±1.51 days in the ciprofloxacin treatment group and 2.26±1.71 days in the 3rd cephalosporin treatment group. Conclusions Campylobacter enterocolitis was common during summer. Commonly healthy young adults were hospitalized due to severe symptoms of Campylobacter enterocolitis. Whole colon and small bowel were frequently involved. Most patients were treated with antibiotics, and the efficacy of 3rd cephalosporin treatment was not inferior to that of ciprofloxacin treatment.

Primary esophageal lymphoma is very rare, and most reported cases are histologically mucosa-associated lymphoid tissue lymphoma. Therefore, the principle treatment strategy for primary esophageal lymphoma focuses on local treatments, such as endoscopic mucosal resection or radiation therapy, but systemic chemotherapy plays the central role in the treatment of diffuse large B cell lymphoma (DLBCL). Generally, standard treatment for DLBCL is six or three cycles of R-CHOP chemotherapy followed by involved field radiation therapy according to stage. However, the optimal treatment strategy for primary esophageal DLBCL, and the role of additional radiation is not settled, due to a paucity of cases. Moreover, the clinical characteristics related to the etiology and natural course are also unknown. Here, we present two cases of primary esophageal DLBCL with a literature review.
Drug Therapy ; Esophagus ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Large B-Cell, Diffuse

Invasive infection of the Streptococcus bovis group in a neonate is rare. In cases reported to date, the pathogen of neonatal S. bovis infections is usually Streptococcus gallolyticus subsp. pasteurianus (S. bovis biotype II/2). Streptococcus lutetiensis (S. bovis biotype II/1) was identified using 16S rRNA and tuf gene sequence analysis of the isolates from blood and cerebrospinal fluid (CSF) of a fever-presenting 28-day-old male. Blood culture analysis was performed using automatic equipment (VITEK 2) and identified Streptococcus infantarius supsp. infantarius, yet we were unable to get accurate results from the CSF culture. The fever subsided on the second day of hospitalization, and the patient was discharged without neurologic complication after 14 days of antibiotic therapy. In this case, we were able to accurately identify the pathogen using molecular genetic methods. To our knowledge, this is the first case of late onset neonatal bacteremia and meningitis caused by S. lutetiensis.
Bacteremia* ; Cerebrospinal Fluid ; Fever ; Hospitalization ; Humans ; Infant, Newborn ; Male ; Meningitis* ; Molecular Biology ; Sequence Analysis ; Streptococcus bovis ; Streptococcus*

BACKGROUND: Treatment outcomes of children with non-Hodgkin lymphoma (NHL) have dramatically improved in recent years. However, there are few studies on the outcomes of pediatric NHL in Korea.METHODS: We retrospectively analyzed the outcomes of 34 children diagnosed with NHL and treated at Kosin University Gospel Hospital from Jan. 1987 to Dec. 2009, according to age, lactate dehydrogenase (LDH) level, histology, stage and involved site.RESULTS: The mean age of the subjects was 9.0 years. The abdomen and head/neck regions were the most common primary sites. On histologic classification, Burkitt lymphoma was the most common, followed by lymphoblastic lymphoma, diffuse large B-cell lymphoma, anaplastic large cell lymphoma, and unclassifiable, with respective incidences of 35.3%, 23.5%, 17.6%, 17.6%, and 5.9%. Various combination chemotherapies according to the diagnosis with mean treatment duration of 14.9 months showed 5 year event free survival (EFS) and 5 year overall survival (OS) rate of 67.7+/-8.0% and 79.3+/-7.0%, respectively. Nine out of the 34 patients relapsed, and the 5 year OS rates for those who relapsed vs. 25 patients without relapse were 44.4+/-16.6%, vs. 92.0+/-5.4%, respectively (P<0.01). Although 5 year EFS rate varied according to stage, 5 year OS rate were not different according to age, sex, LDH, stage, histology, or treatment period.CONCLUSION: The outcome of children with NHL treated in our setting was comparable to those of other large centers in Korea. No factor other than stage, including LDH, histologic subtype showed significant prognostic value.
Abdomen ; Burkitt Lymphoma ; Child ; Classification ; Diagnosis ; Disease-Free Survival ; Drug Therapy, Combination ; Humans ; Incidence ; Korea ; L-Lactate Dehydrogenase ; Lymphoma, B-Cell ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, Non-Hodgkin ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Recurrence ; Retrospective Studies

The pneumonia severity index (PSI) and CURB-65 are widely used tools for the prediction of community-acquired pneumonia (CAP). This study was conducted to evaluate validation of severity scoring system including the PSI and CURB-65 scores of Korean CAP patients. In the prospective CAP cohort (participated in by 14 hospitals in Korea from January 2009 to September 2011), 883 patients aged over 18 yr were studied. The 30-day mortalities of all patients were calculated with their PSI index classes and CURB scores. The overall mortality rate was 4.5% (40/883). The mortality rates per CURB-65 score were as follows: score 0, 2.3% (6/260); score 1, 4.0% (12/300); score 2, 6.0% (13/216); score 3, 5.7% (5/88); score 4, 23.5% (4/17); and score 5, 0% (0/2). Mortality rate with PSI risk class were as follows: I, 2.3% (4/174); II, 2.7% (5/182); III, 2.3% (5/213); IV, 4.5% (11/245); and V, 21.7% (15/69). The subgroup mortality rate of Korean CAP patients varies based on the severity scores and CURB-65 is more valid for the lower scores, and PSI, for the higher scores. Thus, these variations must be considered when using PSI and CURB-65 for CAP in Korean patients.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Cohort Studies ; Community-Acquired Infections/*mortality ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Pneumonia/*mortality ; Prospective Studies ; Republic of Korea ; *Severity of Illness Index ; Young Adult

BACKGROUND: Hepatitis C virus (HCV) RNA quantification is necessary for predicting the therapeutic response and assessing treatment results in patients with chronic HCV infection. Recently, real-time PCR technology for HCV RNA quantification displayed good linearity within the dynamic range. Thus, it is gradually replacing branched-DNA (bDNA) and PCR- hybridization assays. In this study, we evaluated the performance of the Real-QTM HCV quantification kit (biosewoom. Inc., Seoul, Korea) developed in Korea. METHODS: We evaluated the HCV quantification kit for detection limit, specificity, linearity, accuracy, and recovery rate of HCV RNA standard material. The results were analyzed for a correlation with those of Cobas Amplicor HCV Monitor 2.0. RESULTS: The HCV quantification kit showed a high recovery rate of HCV RNA standard material of various concentrations and amplication of HCV RNA equally in all genotypes. Hepatitis B virus and human immunodeficiency virus showed no cross-reactivity with HCV. Within-run and between-run coefficients of variation (CV) were 9.52~15.84% and 9.40~17.53%, respectively. Between-day coefficients of variation were 11.62~18.04%, and detection limit was 44 IU/mL. It showed a good correlation with Cobas Amplicor HCV Monitor 2.0 (R2=0.8954). CONCLUSION: The Real-Q HCV quantification kit showed a good specificity, sensitivity, linearity, and accuracy; therefore, we propose that it is fully adequate for monitoring antiviral therapy in patients with chronic HCV infection.
Chimera ; Genotype ; Hepacivirus ; Hepatitis B virus ; HIV ; Humans ; Limit of Detection ; Organothiophosphorus Compounds ; Real-Time Polymerase Chain Reaction ; RNA ; Sensitivity and Specificity

BACKGROUND: Infection with human papilloma virus (HPV) is the main cause of cervical cancer, and HPV genotyping is of increasing importance for determining clinical course and management of the disease based on the HPV genotypes. Here, we established a novel matrix-assisted laser desorption/ ionization time of flight mass spectrometry (MALDI-TOF MS) assay, termed restriction fragment mass polymorphism (RFMP) that is suitable for genotyping multiple HPV in an accurate and high-throughput manner. We evaluated the performance of the RFMP assay in HPV genotyping by comparing the results with those of direct or clonal sequencing and hybrid capture (HC) assays. METHODS: The study population consisted of 50 patients with histologically confirmed cervical lesions and a positive test for HPV DNA. HPV genotyping was performed with RFMP, sequencing, and HC assays. The assigned genotypes and risk groups were compared among the methods. RESULTS: Concordance rates in the genotype level between RFMP vs sequencing, sequencing vs HC, and HC vs RFMP were 98% (49/50), 88% (44/50), and 88% (44/50), respectivley. Especially, RFMP and sequencing were 100% concordant when assigned high-risk group was considered identical in 1 case of mixed genotypes identified only in RFMP. The observed discrepancy between HC and the other two methods is due to the assignment of six cases of low, intermediate, or unassigned risk genotypes as high-risk group in HC method. CONCLUSIONS: RFMP, sequencing, and HC assays were highly concordant with each other in HPV genotyping. Compared to sequencing assay, RFMP assay is found to be advantageous in detecting mixed genotype infections. The accuracy and amenability to high-throughput analysis should make the RFMP assay suitable for reliable screening of HPV genotypes in clinical laboratories.
Female ; Genotype ; Humans ; Nucleic Acid Hybridization/methods ; Papillomaviridae/classification/genetics/*isolation & purification ; Papillomavirus Infections/*diagnosis ; Polymorphism, Restriction Fragment Length ; Sequence Analysis, DNA/methods ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization/*methods ; Uterine Cervical Neoplasms/*diagnosis

BACKGROUND: The polymorphisms, C677T and A1298C in the methylenetetrahydrofolate reductase (MTHFR) gene express a decreased enzyme activity. These polymorphic variants are known to decrease the risk of some malignancies. We examined whether the polymorphisms in MTHFR gene play a role in childhood acute lymphoblastic leukemia (ALL). METHODS: Peripheral blood or bone marrow samples were collected from 99 ALL patients aged <16 years and 105 age and sex matched controls. We performed PCR-restriction fragment length polymorphism with HinF1 for C677T and MboII A1298C. RESULTS: The frequencies of 677CC, 677CT, and 677TT genotypes were 43.4%, 46.5% and 10.1% in patients and 39.0%, 45.7%, and 15.2% in controls. The 677TT variants seemed to decrease the risk for ALL than the 677CC genotype, but the difference was not statistically significant (OR=0.60, 95% CI=0.2-1.5). The frequencies of 1298AA, 1298AC, and 1298CC genotype were 66.7%, 26.3% and 7.1% in patients and 60.0%, 38.1% and 1.9% in controls. The 1298CC genotype seemed to increase the risk for ALL than 1298AA, but without statistical significance (OR=3.34, 95% CI=0.7- 18.1). These findings were more evident in the patient groups with hyperploid and translocation than those with normal karyotypes. CONCLUSIONS: In our series, MTHFR C677T and A1298C polymorphism did not show a statistically significant protective effect for the childhood ALL.
Bone Marrow ; Genotype ; Humans ; Karyotype ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*

The Word Health Organization defines Mantle cell lymphoma (MCL), comprising two main morphological variant, blastoid and other variant. The classic type of blastoid variant show proliferation of lymphocytes, resembling lymphoblasts, with scant cytoplasm, rounded nuclei with fine dispersed chromatin and inconspicuous nucleoli. The blastoid variant is virtually indistinguishable from acute lymphoblastic leukemia based on blood and bone marrow morphology. We report one case of blastic mantle cell leukemia diagnosed by the immunophenotyping results and the detection of cyclin D1 overexpression on immunohistochemical stain.
Bone Marrow ; Chromatin ; Cyclin D1 ; Cytoplasm ; Immunophenotyping ; Leukemia* ; Lymphocytes ; Lymphoma, Mantle-Cell ; Precursor Cell Lymphoblastic Leukemia-Lymphoma

Interferon-alpha is an established therapy for the patients with myeloproliferative disease. Unusual immune-mediated side effects have been reported during treatment. Among them, renal and cardiac toxicities are rare complications. Recently we experienced a case of hemolytic uremic syndome found in a 40-year old male undergoing interferon-alpha therapy for chronic myelogenous leukemia, chronic phase. On admission, his chief complaints were generalized edema and azotemia. Bone marrow biopsy revealed transformation into accelerated phase. bcl/abl gene was positive. Peripheral blood smear showed hemolytic anemia. Despite prompt diagnosis, institution of plasmapheresis, and steroid, his renal function did not recover, as expected. Hemolytic uremic syndrome was a chronic form of renal toxicity due to interferon-alpha. In this case, renal function did not recovered to normal level. However, early detection of renal toxicity such as proteinuria or acute tubular necrosis, and the discontinuation of interferon-alpha could achieve the recovery of normal renal function. Therefore, periodic examination of renal function should be performed in the patients with the use of long-term interferon-alpha.
Adult ; Anemia, Hemolytic ; Azotemia ; Biopsy ; Bone Marrow ; Diagnosis ; Edema ; Hemolytic-Uremic Syndrome ; Humans ; Interferon-alpha* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Male ; Necrosis ; Plasmapheresis ; Proteinuria