Eosinophilic granulomatosis with polyangitis (EGPA) should be considered in asthmatic patients who present with severe systemic symptoms and eosinophilia. Progressive renal insufficiency can occur during the acute phase of EGPA accompanied by renovascular involvement. A 58-year-old man visited local clinic with complaints of malaise, weight loss, fever, and dyspnea. Eosinophilia was revealed in peripheral blood. Pulmonary function tests were carried out, which yielded decreased lung function with positive bronchodilator response. Kidney and skin biopsies were performed, and histological examination showed acute necrotizing crescentic glomerulonephritis and leukoclastic vasculitis in the skin, which led to a diagnosis of EGPA (Churg-Strauss syndrome) associated with rapidly progressive glomerulonephritis. The patient received pulse steroid therapy with parenteral methylprednisolone, followed by oral prednisolone. Clinical and laboratory findings improved dramatically, and remission was attained rapidly. The patient continued to be in remission for 5 months. Prompt and aggressive treatment with systemic corticosteroids is mandatory to control disease activity and to achieve remission.
Adrenal Cortex Hormones ; Biopsy ; Churg-Strauss Syndrome ; Diagnosis ; Dyspnea ; Eosinophilia ; Eosinophils* ; Fever ; Glomerulonephritis* ; Humans ; Kidney ; Lung ; Methylprednisolone ; Middle Aged ; Prednisolone ; Renal Insufficiency ; Respiratory Function Tests ; Skin ; Vasculitis ; Weight Loss

The aim of this study was to applicate and evaluate a SYBR Green real-time PCR for the specific detection of Salmonella spp. Specificity of the PCR method was confirmed with 48 Salmonella spp. and 5 non-Salmonella strains using invA gene primer. The average threshold cycle (C(T)) of Salmonella spp. was 11.83 +/- 0.78 while non-Salmonella spp. was 30.86 +/- 1.19. Correlation coefficients of standard curves constructed using C(T) versus copy number of Salmonella Enteritidis ATCC 13076 showed good linearity (R2 = 0.993; slope = 3.563). Minimum level of detection with the method was > 10(2) colony forming units (CFU)/mL. These results suggested that the SYBR Green real-time PCR might be applicable for the specific detection of Salmonella spp. isolates.
Coat Protein Complex I ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction ; Salmonella ; Salmonella enteritidis ; Sensitivity and Specificity ; Stem Cells

Salmonella (S.) Typhimurium and S. Enteritidis are the major causative agents of food-borne illnesses worldwide. Currently, a rapid detection system using multiplex real-time polymerase chain reaction (PCR) has been applied for other food-borne pathogens such as Escherichia coli, Staphylococcus aureus and Streptococcus spp. A multiplex real-time PCR was developed for the simultaneous detection of Salmonella spp., especially S. Typhimurium and S. Enteritidis, in beef and pork. For the specific and sensitive multiplex real-time PCR, three representative primers and probes were designed based on sequence data from Genbank. Among the three DNA extraction methods (boiling, alkaline lysis, and QIAamp DNA Mini Kit), the QIAamp DNA Mini Kit was the most sensitive in this study. The optimized multiplex real-time PCR was applied to artificially inoculated beef or pork. The detection sensitivity of the multiplex real-time PCR was increased. The specificity of the multiplex real-time PCR assay, using 128 pure-cultured bacteria including 110 Salmonella isolates and 18 non-Salmonella isolates, was 100%, 100% and 99.1% for Salmonella spp., S. Typhimurium and S. Enteritidis, respectively. The sensitivity was 100%, 100% and 91.7% for Salmonella spp., S. Typhimurium and S. Enteritidis, respectively. The multiplex real-time PCR assay developed in this study could detect up to 0.54 +/- 0.09 and 0.65 +/- 0.07 log10 CFU/ml for S. Typhimurium and S. Enteritidis for beef, 1.45 +/- 0.21 and 1.65 +/- 0.07 log10 CFU/ml for S. Typhimurium and S. Enteritidis for pork, respectively, with all conditions optimized. Our results indicated that the multiplex real-time PCR assay developed in this study could sensitively detect Salmonella spp. and specifically differentiate S. Typhimurium from S. Enteritidis in meats.
Animals ; Cattle ; DNA, Bacterial ; *Food Microbiology ; Meat/*microbiology ; Polymerase Chain Reaction/*veterinary ; Salmonella/*isolation & purification ; Sensitivity and Specificity ; Swine

PURPOSE: Intramedullary cartilage forming tumors in the meta-diaphysis of the long bones can represent an enchondroma or a low-grade chondrosarcoma, with the latter requiring adequate surgical treatment. However, these two lesions have overlapping clinical and histological features and so they pose a diagnostic and therapeutic dilemma. The purpose of this study was to analyze the clinical outcome and to determine the relevant clinical and radiographic parameters for deciding on the treatment for these tumors. MATERIALS AND METHODS: We conducted a retrospective review of 73 patients who were treated for enchondroma or low-grade chondrosarcoma that was located in the metaphysis or diaphysis of the bones. There were 20 men and 53 women with an average age of 49 years (range: 18-80). The locations were the proximal humerus (n=34), distal femur (24), proximal femur (6), proximal tibia (3), proximal fibula (2), humerus shaft (2) and femur shaft (2). 41 patients were treated surgically and 32 patients were simply observed based on the following parameters at presentation; the presence of pain, the tumor length and radiographic evidence of endosteal erosion. RESULTS: All of the 32 patients who were initially observed had no evidence of disease progression at the last follow-up (average: 3.2 years, range: 1.0-14.9). Forty (98%) of the surgically treated patients showed no recurrence at the the last follow-up (average: 4.3 years, range: 1.0-14.0). CONCLUSION: The presence of pain, tumor length and radiographic evidence of endosteal erosion should be considered to determine the best course of treatment for intramedullary cartilage forming tumors in the meta-diaphysis of the long bones. With the appropriate selection of the patients, these tumors can be successfully treated nonoperatively.
Cartilage ; Chondroma ; Chondrosarcoma ; Decision Making ; Diaphyses ; Disease Progression ; Female ; Femur ; Fibula ; Follow-Up Studies ; Humans ; Humerus ; Male ; Recurrence ; Retrospective Studies ; Tibia

FLT3 mutations are common genetic changes, and are reported to have prognostic significance in acute myeloid leukemia (AML). The FLT3 internal tandem duplication (ITD) and the D835 activating mutation in the tyrosine kinase domain (TKD) were analyzed by polymerase chain reaction (PCR) in the genomic DNA of Korean patients with AML at diagnosis and during follow-up. There were 226 patients with AML enrolled between March 1996 and August 2005. The incidence of ITD and TKD at diagnosis was 13% (29/226) and 3% (6/226). When compared to Western and other Asian patients with AML, Korean patients had a lower frequency by about two-thirds of ITD and TKD. Among the non-M3 cases (N=203), the patients with an ITD had a significantly shorter event-free survival when compared with those without an ITD (p=0.0079). Among 54 relapsed patients, 9 patients had the FLT3 ITD at diagnosis. Six patients demonstrated a reappearance of the ITD and 3 patients remained negative at relapse. One patient, among 45 patients who relapsed, had a negative baseline ITD but acquired a de novo ITD at relapse. There were 101 samples from 93 patients in remission; they were all negative for an ITD. Among 34 patients who failed to achieve a remission, five patients had a persistent ITD and one patient had a de novo ITD. These results support the concept of resistance of FLT3 ITD leukemic clones to chemotherapy. Therefore, effective therapy with FLT3 targeting agents may improve the prognosis of non-M3 AML patients with the FLT3 mutation.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Disease-Free Survival ; Female ; *Gene Expression Regulation, Neoplastic ; Humans ; Infant ; Infant, Newborn ; Korea ; Leukemia, Myeloid, Acute/*genetics ; Male ; Middle Aged ; *Mutation ; Prognosis ; Recurrence ; Remission Induction ; fms-Like Tyrosine Kinase 3/*genetics

BACKGROUND: This is the first annual data on the surveillance of intensive care unit (ICU) module by the Korean Nosocomial Infections Surveillance System (KONIS) from July 2007 through June 2008. METHODS: The KONIS performed a prospective surveillance for nosocomial urinary tract infections (UTI), bloodstream infections (BSI), and pneumonia (PNEU) at 96 ICUs in 56 hospitals. Nosocomial infection (NI) rates were calculated as the numbers of infections per 1,000 patient-days or device-days. RESULTS: A total of 2,637 NIs were found during the study period; 1,391 UTIs (1,365 cases were urinary catheter-associated), 667 BSIs (563 were central line-associated), and 579 PNEUs (357 were ventilator-associated). The rate of urinary catheter-associated UTIs was 4.43 cases per 1,000 device-days (95% confidence interval, 4.20-4.67) and urinary catheter utilization ratio was 0.84 (0.839-0.841). The rate of central line-associated BSIs was 2.83 (2.61-3.07) and the utilization ratio was 0.54 (0.538-0.542). The rate of ventilator-associated PNEUs was 2.49 (2.25-2.76) and the utilization ratio was 0.39 (0.388-0.392). Although the ventilator utilization ratios were lower in the hospitals with less than 900 beds than in the hospitals with more than 900 beds, the rates of ventilator-associated PNEUs were higher in the smaller hospitals than in the larger ones. CONCLUSION: This result suggests that ongoing targeted surveillance and implementation of proven infection control strategies are needed.
Cross Infection ; Infection Control ; Critical Care ; Intensive Care Units ; Pneumonia ; Prospective Studies ; Urinary Catheters ; Urinary Tract Infections ; Ventilators, Mechanical

PURPOSE: This study aims to compare the efficacy and safety of propiverine hydrochloride (propiverine) 40mg for the treatment of overactive bladder (OAB). MATERIAL AND METHODS: Total of 284 patients (male:86, female:198) with OAB were included in this study. The patients were treated with propiverine 20mg twice daily or 40mg once daily for 8 weeks. The initial evaluation included with history taking, physical examination, International Prostatic Symptom Score (IPSS), IPSS QoL and consecutive voiding diaries for 3 days. After a 8-week treatment, IPSS, IPSS QoL, patients perception of treatment benefit, global assessment of efficacy by physicain and safety were evaluated. RESULTS: Two hundred eighteen patients were treated with propiverine 20mg twice daily and 66 patients treated with 40mg once daily. The 59 patients had been treated previously with anticholinergics. After a 8-week treatment, IPSS score (total, voiding and storage subscore) and IPSS QoL were improved in all patients (p<0.05). After a 8-week with propiverine 40mg once daily, improvement of IPSS score was noted in the patients non-responsive to anticholinergics previously (p<0.05). The patients treated with propiverine 40mg once daily showed much more symptomatic improvements assessed by physicians than 20mg twice daily (p<0.05). The overall side effect was noted in the 13.4% patients and the most common side effect was dry mouth. CONCLUSION: Propiverine 40mg once daily is considered to reduce the symptom of OAB effectively and can be used safely in the patients with OAB. Treatment with propiverine 40mg is seemed to show more improvement in the unsatisfactory patients with previous anticholinergics.
Cholinergic Antagonists ; Humans ; Mouth ; Observational Study* ; Physical Examination ; Prospective Studies* ; Treatment Outcome ; Urinary Bladder, Overactive*

BACKGROUND: THe Korean Society for Nosocomial Infection Control (KOSNIC) orfanized the Korean Nosocomial Infections Surveillance System (KONIS) to establish a nationwide database of Nosocomial infection (NI) rate in the intensive care units (ICUs) of Korean hospitals. This report is a summary of the data from July through September 2006. METHODS: The KONIS performed a prospective sruveillance for nosocomial urinary tract infections (UTI), bloodstream infections (BSI), and pneumonia (PNEU) at 76 ICUs in 44 hospitals. NI rates were calculated as the numbers of infections per 1,000 patient-days or device-days. RESULTS: A total of 846 nosocomial infections were fOlllld during the study period: 407 UTIs (397 cases were urinary catheter-associated), 204 BSIs (182 were central line-associated), and 235 PNEUs (161 were ventilator-associated). The rate of urinary catheter-associated UTIs was 4.61 cases per 1,000 device-days and urinary catheter utilization ratio was 0.83. The rate of central line-associated BSIs was 3.16 and the utilization ratio was 0.55. The rate of ventilator-associated PNEUs was 3.80 and the utilization ratio was 0.41. Although the ventilator utilization ratio was lower in the hospitals with 400-699 beds than in the hospitals with more than 900 beds, the rate of ventilator-associated pneumonia was higher in the smaller hospitals than in the larger ones. The rates of all three device-associated infections were the highest in the neurosurgical ICUs and the rates were the lowest in the surgical ICUs. CONCLUSION: This study may contribute to the development of effective strategies for NI control according to the size of hospital and the type of ICUs.
Cross Infection* ; Intensive Care Units ; Pneumonia ; Pneumonia, Ventilator-Associated ; Prospective Studies ; Urinary Catheters ; Urinary Tract Infections ; Ventilators, Mechanical

BACKGROUND: Korean Nosocomial Infections Surveillance System (KONIS) operating since July 2006 is the first nationwide monitoring system for nosocomial infections in the in the intensive care unit (lCU) with a standard protocol and web-based prompt response network in Korea. This report describes the characteristics of the KONIS hospitals compared with those of all Korean hospitals with 400 beds and over. METHODS: A survey was conducted for the 44 hospitals participating in KONIS 2006, and the data were rechecked by the KONIS hospitals through KONIS web-network. The survey form included questions about the size of the hospital, infection control personnel, nursing personnel, and the status of microbiologic laboratory. RESULTS: Compared to all Korean hospitals with 400 beds and over, the KONIS hospitals were larger in term of average number of beds (857 vs 654); the number of hospitals with 700 beds and over was over-represented in Seoul (P=0.01) and under-represented in the central/south area (P<0.001) The majority of the KONIS hospitals were major teaching university-affiliated (88,6%) and private (72.7%), but in the central/south area, public hospitals comprised up to 60%. The number of infection control professionals (ICP) averaged 1.6, hospital beds per ICP 531, and infectious disease physicians 1.3. Medical and medical combined ICUs were the major component (67,1%) of the KONIS ICUs, The lCU bed per nurse was 0.63. CONCLUSION: The KONIS 2006 hospitals were over-represented in the overall indicators in Seoul. Because no objective indicators were available regarding the patient quality, KONIS data must be interpreted in consideration of all indicators.
Communicable Diseases ; Cross Infection* ; Hospitals, Public ; Humans ; Infection Control ; Intensive Care Units ; Korea ; Nursing ; Seoul

Nocardiosis is usually a subacute infection, which can occur as an opportunistic infections in patients with systemic lupus erythematosus. There are rare cases of nocardiosis concurrent with Mycobacterium tuberculosis. We report a case of intramuscular nocardial abscess concurrent with pulmonary tuberculosis in a patient with lupus nephritis. She has received cyclophosphamide pulse therapies and is receiving oral steroid therapy 3 months ago. After Nocardia farcinica and Mycobacterium tuberculosis were confirmed by PCR and PCR-RFLP, we initiated trimethoprim/ sulfamethoxazole and antituberculous agents. After then, patient was improved and discharged, maintaining the medications.
Abscess* ; Cyclophosphamide ; Humans ; Lupus Erythematosus, Systemic ; Lupus Nephritis* ; Mycobacterium tuberculosis ; Nocardia Infections ; Nocardia* ; Opportunistic Infections ; Polymerase Chain Reaction ; Sulfamethoxazole ; Tuberculosis, Pulmonary*