A 4-year-old Holstein cow with progressive atrophy and ataxia was submitted for diagnosis. The postmortem examination revealed multifocal yellowish nodules in the pulmonary parenchyma and vegetative masses in the mitral and tricuspid valve of the heart. Both kidneys were severely enlarged, with multiple yellow nodules on the parenchyma. Histopathologically, pulmonary abscesses, vegetative endocarditis, suppurative glomerulonephritis, and fibrino-purulent arthritis were observed. The tiny β-hemolytic bacterial colonies were isolated from the lesions and identified as Arcanobacterium haemolyticum by the Vitek 2 system (bioMérieux, USA). This is the first documented report of an A. haemolyticum infection in a Holstein cow in Korea.

The purpose of the present study was to investigate changes in hematological and serum biochemical parameters in ponies exercising 3 times a day. The study included 10 healthy 4- to 5-year-old Jeju crossbred ponies used in riding lessons at an equestrian riding school. Hematology and serum chemistry samples were obtained before the initial lesson and after the last lesson of the day. The post-exercise results showed that packed cell volume, white blood cell, red blood cell, hemoglobin, and total protein levels increased significantly (p < 0.05). Serum Na + also increased significantly (p < 0.01), but serum Ca ++ decreased significantly p < 0.01).Creatinine kinase, aspartate amino transferase, gamma glutamyl transferase, blood urea nitrogen, creatinine, and bilirubin levels increased significantly (p < 0.05), but the glucose level decreased significantly (p < 0.05). Furthermore, the serum cortisol hormone level increased significantly (p < 0.01). The results suggest that participating in riding lessons three times a day may result in various physiological changes, indicating the presence of exercise-related stress in riding ponies.

BACKGROUND: This study examines the clinical and radiologic results of ceramic-on-ceramic total hip arthroplasties with regard to wear, osteolysis, and fracture of the ceramic after a minimum follow-up of six years. METHODS: We evaluated the results of a consecutive series of 148 primary ceramic-on-ceramic total hip arthroplasties that had been performed between May 2001 and October 2005 in 142 patients. The mean age was 57.2 years (range, 23 to 81 years). The mean follow-up period was 7.8 years (range, 6.1 to 10.1 years). Preoperative diagnosis was avascular necrosis in 77 hips (52%), degenerative arthritis in 36 hips (24.3%), femur neck fracture in 18 hips (12.2%), rheumatoid arthritis in 15 hips (10.1%), and septic hip sequelae in 2 hips (1.4%). Clinical results were evaluated with the Harris hip score, and the presence of postoperative groin or thigh pain. Radiologic analysis was done with special attention in terms of wear, periprosthetic osteolysis, and ceramic failures. RESULTS: The mean Harris hip score improved from 58.3 (range, 10 to 73) to 92.5 (range, 79 to 100) on the latest follow-up evaluation. At final follow-up, groin pain was found in 4 hips (2.7%), and thigh pain was found in 6 hips (4.1%). Radiologically, all femoral stems demonstrated stable fixations without loosening. Radiolucent lines were observed around the stem in 25 hips (16.9%), and around the cup in 4 hips (2.7%). Endosteal new bone formation was observed around the stem in 95 hips (64.2%) and around the cup in 88 hips (59.5%). No osteolysis was observed around the stem and cup. There were 2 hips (1.4%) of inclination changes of acetabular cup, 2 hips (1.4%) of hip dislocation, 1 hip (0.7%) of ceramic head fracture, and 1 hip (0.7%) of squeaking. The Kaplan-Meier survival rate of the prostheses was 98.1% at postoperative 7.8 years. CONCLUSIONS: The ceramic-on-ceramic total hip arthroplasty produced excellent clinical results and implant survival rates with no detectable osteolysis on a minimum six-year follow-up study. The ceramic-on-ceramic couplings could be a reasonable option of primary total hip arthroplasty for variable indications.
Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip/adverse effects/instrumentation/*methods ; *Ceramics ; Female ; Follow-Up Studies ; Hip Joint/radiography/surgery ; *Hip Prosthesis ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Pain, Postoperative/etiology ; Prosthesis Failure ; Range of Motion, Articular

BACKGROUND: Parainfluenza virus (PIV) is a significant cause of acute respiratory infections. Epidemiological information on PIV infection could be very helpful for patient management. The aim of this study was to investigate the epidemiology of PIV infection in Seoul and a neighboring area with regard to PIV type. METHODS: The diagnosis of PIV infection was made by virus isolation. The R-mix Too cell system (Diagnostic Hybrids, Inc., Athens, OH, USA) and D3 Ultra DFA Respiratory Virus Screening & ID kits (Diagnostic Hybrids, Inc.) were used for virus culture and identification. The medical records of patients with positive virus cultures were reviewed retrospectively. RESULTS: Seven hundred and ten PIV viruses (5.6%) were isolated from 12,723 specimens. The number of subjects with PIV type III, I and II was 357, 304 and 49, respectively. PIV infection showed a peak incidence in the first year of life regardless of subtypes. The most common diagnosis among all PIV subtypes was pneumonia. Lower respiratory tract infections constituted the majority (76.3%) of PIV infections. The most common diagnosis of PIV type I and II was croup and that of PIV type III was pneumonia. A difference in seasonal variation between subtypes was observed. PIV I (62.2%) was mainly isolated from July to September while PIV type III (86.8%) was isolated from April to July. CONCLUSION: Lower respiratory infection was most commonly found in hospitalized patients with PIV infection. Clinical features of PIV infection were similar those seen in Western PIV reports, with the exception of the seasonal outbreak pattern.
Chimera ; Croup ; Humans ; Incidence ; Mass Screening ; Medical Records ; Parainfluenza Virus 1, Human ; Paramyxoviridae Infections ; Pneumonia ; Respiratory Tract Infections ; Seasons ; Viruses

PURPOSE: To evaluate the radiologic results between compressive hip screw and compressive hip screw with additional trochanteric stabilizing plate in patients with femoral unstable intertrochanteric fractures in patients with more 65 years old. MATERIALS AND METHODS: From 2006 to May 2009, 121 cases were included. Group I (compressive hip screw only) was 54 cases and group II (compressive hip screw with trochanteric stabilizing plate) was 67 cases. We checked the lag screw sliding, lateral translation of greater trochanter, changes of neck-shaft angle and complications through periodic follow up of radiographs. RESULTS: Mean lag screw sliding was 7.6 mm in group I and 3.9 mm in group II (p=0.001). Mean lateral translation of greater trochanter was 3.86 mm in group I and 0.59 mm in group II (p=0.01). Mean changes of neck-shaft angle was nearly the same, 3.57degrees in group I and 3.66degrees in group II. Complications were 15 cases in group I and 10 cases in group II. CONCLUSION: Compressive hip screw with additional trochanteric stabilizing plate was effective surgical option in patients with femoral unstable intertrochanteric fractures in patients with more than 65 years old. It decreased lag screw sliding, lateral translation of greater trochanter and complication rates.
Aged ; Femur ; Follow-Up Studies ; Hip ; Hip Fractures ; Humans

Limitations due to lack of appropriate available donors for liver transplantation necessitates the use of ABO-mismatched donors. Transplantation of ABO-mismatched solid organs is sometimes associated with the development of immune hemolytic anemia, which is caused by production of antibodies by the donor B lymphocytes in a primary or secondary immune response against the recipient's red blood cell antigens. This condition is referred to as Passenger Lymphocyte Syndrome (PLS). PLS is more frequent in heart and lung transplants than in liver and kidney transplants with incidence of PLS in liver transplantation at 30~40%. When present, PLS typically manifests 1~3 weeks after transplantation, and subsides within 3 months after symptoms are first detected. In most patients, PLS is self-limiting and exhibits mild symptoms, but in some cases PLS can be life-threatening. We report a case of immune hemolytic anemia after an ABO-mismatched liver transplantation involving a blood group O donor and a blood group A recipient, and successful treatment of the resulting PLS symptoms by transfusion of gamma-irradiated group O Red Blood Cells (RBCs) accompanied by administration of 60 mg/day of methylprednisolone for 1 week.
Anemia, Hemolytic ; Antibodies ; B-Lymphocytes ; Erythrocytes ; Heart ; Humans ; Incidence ; Kidney ; Liver ; Liver Transplantation ; Lung ; Lymphocytes ; Methylprednisolone ; Tissue Donors ; Transplants

BACKGROUND: Laboratory diagnosis of new influenza A (H1N1) is crucial for managing patients and establishing control and prevention measures. We compared the diagnostic accuracies of the real time RT-PCR (rRT-PCR) test recommended for the confirmation of the new flu and the viral culture method used conventionally for viral disease with that of the rapid antigen test (RAT). METHODS: We performed RAT, R-mix culture, and real-time PCR by using 861 respiratory samples collected from December 2009 to January 2010 and evaluated the abilities of these methods to detect new influenza A. The relationship among the positive rates of RAT, grades of culture, and the cycle threshold (Ct) values of rRT-PCR was also evaluated. RESULTS: Of the 861 patients, 308 (35.8%) were diagnosed with new influenza A. The sensitivities, specificities, positive predictive values, and negative predictive values of the tests were respectively as follows: 59.7%, 99.5%, 98.4%, and 81.6% for RAT; 93.2%, 100%, 100%, and 96.3% for R-mix culture; and 95.8%, 100%, 100%, and 97.7% for rRT-PCR. Samples with weak positive grade in culture and those with Ct values of 30-37 in rRT-PCR showed positivities as low as 25.3% and 2.3% in RAT, respectively. The hospitalization rate and death rate of the confirmed patients were 3.2% and 0.3%, respectively, and gastrointestinal symptoms were observed in 7.2% of the patients. CONCLUSIONS: R-mix culture and rRT-PCR tests showed excellent reliability in the diagnosis of new influenza A and could be very useful, especially for samples with low viral load.
Animals ; Clinical Laboratory Techniques ; Hospitalization ; Humans ; Influenza, Human ; Korea ; Pandemics ; Rats ; Real-Time Polymerase Chain Reaction ; Viral Load ; Virus Diseases

BACKGROUND: Some researchers have questioned the necessity of adjusting glomerular filtration rate (GFR) by body surface area (BSA). We compared the relationship between estimated GFR (eGFR) and radionuclide GFR (rGFR) with or without BSA adjustment by comparing the results obtained using various formulae with those obtained using 2 new proposed formulae. METHODS: A retrospective study was performed using 204 Korean individuals whose GFR had been estimated by the (99m)Tc-diethylenetriaminepentaacetic acid method between March 2004 and July 2008. We used the modification of diet in renal disease (MDRD) II formula, Mayo clinic quadratic (MCQ) formula, Cockcroft-Gault (CG) formula, and lean body mass-adjusted CG formula. Two new formulae, skeletal muscle mass index (SMI)-adjusted CG formula and SMIx3.4/SCr, were proposed by us. We analyzed each parameter with Pearson's correlation coefficient and also obtained the bias values. RESULTS: BSA did not satisfy the fundamental prerequisites of an adjustment factor for rGFR. MDRD II and MCQ GFR estimates demonstrated higher Pearson's correlation coefficient with BSA-unadjusted rGFR than they did with BSA-adjusted rGFR. The other GFR formulae estimates showed better correlation with rGFR and more favorable bias (P<0.001) when both GFR estimates and rGFR values were BSA-unadjusted. SMI-adjusted CG and SMIx3.4/SCr GFR estimates demonstrated correlation with rGFR and bias values similar to those of the MDRD II and CG GFR estimates. CONCLUSIONS: We suggest that absolute, non-corrected GFR and GFR estimate be preferred in daily practice. The absolute, non-corrected GFR and GFR estimate are considered helpful for patients with eGFR< or =60 mL/min/1.73 m2. We also recommend the clinical use of the new formulae, SMI-adjusted CG and SMIx3.4/SCr (BSA-unadjusted).
Adult ; Aged ; Aged, 80 and over ; Algorithms ; Body Surface Area ; Creatinine/blood ; Female ; *Glomerular Filtration Rate ; Humans ; Male ; Middle Aged ; Organotechnetium Compounds/chemistry ; Pentetic Acid/analogs & derivatives/chemistry ; Republic of Korea/ethnology ; Retrospective Studies

BACKGROUND: The Korean Laboratory Accreditation Program (KLAP) by the Korean Society of Laboratory Medicine (KSLM) was started in 1999. We summarized history and achievement of KLAP for the last 8 yr. METHODS: We analyzed 8 yr data (1999-2006) of historical events, trends of participating laboratories, and scores according to the impact of the question to the outcome of the tests. Inspection check lists are for 'laboratory management', 'clinical chemistry', 'diagnostic hematology', 'clinical microbiology', 'diagnostic immunology', 'transfusion medicine', 'cytogenetics', 'molecular genetics', 'histocompatibility', 'flow cytometry', and 'comprehensive laboratory test verification report'. The laboratories with score 90 or higher got 2-yr certificate and laboratories with score between 60 and 89 got 1-yr certificate. The laboratories with score below 60 failed accreditation. RESULTS: The number of accredited laboratories was 2.4 times higher in 2006 (n=227) than in 1999 (n=96). Inspection check lists have been revised 5 times till 2006. The average accreditation rate was 99.6% during these periods and the 2-yr accreditation rate was 32.4% in 2000, 45.6% in 2001, 53.3% in 2002, 47.3% in 2003, 68.5% in 2004, 37.7% in 2005, and 47.7% in 2006. Number of participants in inspector training workshops increased from 89 in 2000 to 766 in 2006. CONCLUSIONS: The KLAP has been in place successfully and stabilized over the past 8 yr. It seemed to enhance the laboratory quality. Efforts for improvement of quality control and inspector training workshops appeared to be in the main contributing factors.
Accreditation ; Education, Medical, Continuing ; Korea ; Laboratories/*standards ; Pathology, Clinical/*standards ; *Program Evaluation

Piroplasms are tick-transmitted, intracellular, hemoprotozoan parasites that cause anorexia, fever, anemia, and icterus. Theileriosis is caused by Theileria sergenti and causes major economic losses in grazing cattle in Japan and Korea. In May 2003, we examined the antigenic diversity of the major piroplasm surface protein (MPSP) gene in 35 healthy Jeju black cattle that were born and raised at the National Institute of Subtropical Agriculture. On microscopic examination of Giemsa-stained blood smears, 9 of 35 cattle had intra-erythrocytic piroplasms. Hematological data were within normal range for all 35 cattle. Amplification of DNA from all blood samples using universal MPSP gene primers showed mixed infections with C, I, and B type Theileria spp. Type C was identified in 20 of 35 blood samples, and type B was identified in 17 samples. Allelic variation was seen in type B.
Animals ; Antigens, Protozoan/*genetics ; Base Sequence ; Cattle ; DNA Primers/genetics ; *Genetic Variation ; Korea ; Molecular Sequence Data ; *Phylogeny ; Protozoan Proteins/*genetics ; Sequence Analysis, DNA ; Theileria/*genetics ; Theileriasis/*parasitology