Carbapenemase-producing Enterobacteriaceae (CPE) is an important and increasing threat to global health. From July to September 2017, 20 inpatients at a tertiary care hospital in Korea were either colonized or infected with carbapenem-resistant Escherichia coli strains. All of E. coli isolates co-produced bla(NDM-5) and bla(OXA-181) carbapenemase genes and shared ≥88% clonal relatedness on the basis of a cladistic calculation of the distribution of pulsed-field gel electrophoresis patterns. Rapid detection of CPE is one of the most important factors to prevent CPE dissemination because it takes long time for CPE to become negative.

Agranulocytosis is a rare but the most serious life-threatening complication of antithyroid drug therapy. Most cases of agranulocytosis occur within the first 3 months of antithyroid drug therapy, but some cases happen several years after starting treatment. However, there is a paucity of data on the delayed onset of agranulocytosis. We report a case of methimazole-induced agranulocytosis with suppurative pharyngotonsillitis occurring during the long-term treatment. A 48-year-old woman with Graves' disease visited our hospital with sore throat and high fever (39.2degrees C). She had continuously been treated with methimazole for the preceding 7 years-15 to 40 mg daily from Jul 2007 until Apr 2014 and 50 mg daily from May 2014 until September 2014. A month ago, the dose of methimazole had been reduced to 10 mg daily due to transient neutropenia. Her initial blood tests showed an absolute neutrophil count of 40/microL. Moreover, physical examination showed right neck enlargement. We stopped methimazole, and she was empirically treated with broad-spectrum antibiotics and granulocyte colony stimulating factor. Neck CT scan detected enlarged right tonsils and lymph node. Cervical lymph node biopsy only showed acute and chronic inflammation. About 3 weeks after she recovered, 10 mCi of radioiodine ablation therapy was performed. This case suggests that the sign of agranulocytosis should be carefully monitored in patients with Graves' disease, throughout the course of treatment with methimazole, even under the long-term therapy.
Agranulocytosis* ; Anti-Bacterial Agents ; Biopsy ; Colony-Stimulating Factors ; Drug Therapy ; Female ; Fever ; Granulocytes ; Graves Disease* ; Hematologic Tests ; Humans ; Inflammation ; Lymph Nodes ; Methimazole ; Middle Aged ; Neck ; Neutropenia ; Neutrophils ; Palatine Tonsil ; Pharyngitis ; Physical Examination ; Tomography, X-Ray Computed

Acromegaly is a disorder caused by hypersecretion of growth hormone (GH) and insulin-like growth factor-1 (IGF-1). The most common cause of acromegaly is a pituitary GH-producing adenoma. Complete or partial disappearance of the adenoma, probably as a result of hemorrhage or infarction, may lead to empty sella. A case of acromegaly with empty sella syndrome has rarely been reported in Korea. It has been suggested that acromegaly might be associated with the incidence of colon neoplasm. Here, we describe a case of acromegaly with empty sella syndrome in a patient who was diagnosed with colon cancer.
Acromegaly ; Adenoma ; Colon ; Colonic Neoplasms ; Empty Sella Syndrome ; Growth Hormone ; Hemorrhage ; Humans ; Incidence ; Infarction ; Korea

PURPOSE: The short insulin tolerance test is a simple and reliable method of estimating insulin sensitivity. This study was designed to compare the insulin sensitizing effects of thiazolidinediones (TZDs) on the degree of insulin resistance, determined by a short insulin tolerance test (Kitt) in type 2 diabetic patients. PATIENTS AND METHODS: Eighty-three subjects (mean age = 57.87 +/- 10.78) with type 2 diabetes mellitus were enrolled and received daily one dose of rosiglitazone (4mg) or pioglitazone (15mg). The mean follow-up duration was 25.39 +/- 9.66 months. We assessed insulin sensitivity using HOMA-IR and the short insulin tolerance test before and after TZDs treatment. RESULTS: When we compared patients' characteristics before and after TZDs treatment, the mean fasting glucose level was significantly decreased (183.27 +/- 55.04 to 137.35 +/- 36.42mg/dL, p < 0.001) and the mean HbA1C level was significantly decreased (9.24 +/- 1.96 to 8.11 +/- 1.39%, p < 0.001). Also, Kitt values were significantly increased (2.03 +/- 1.14 to 2.67 +/- 0.97%/min, p = 0.003), whereas HOMA-IR was significantly decreased (2.98 +/- 0.68 to 1.04 +/- 0.24, p < 0.05). When classifying insulin resistance by Kitt values, insulin resistant subjects' values were increased (< 2.5%/min; 1.51 +/- 0.53%/min to 2.63 +/- 0.88, p < 0.001), whereas the values decreased in insulin sensitive subjects (> or = 2.5%/min; 3.50 +/- 0.75%/min to 2.75 +/- 1.12%/min, p = 0.002). CONCLUSION: The glucose lowering effects of TZDs by improving insulin resistance could be determined by using Kitt. However, Kitt may be a beneficial tool to determine TZDs' effects only when patients' Kitt values are less than 2.5%/min.
Aged ; Blood Glucose/metabolism ; Diabetes Mellitus, Type 2/blood/*diagnosis/*drug therapy ; Drug Tolerance ; Female ; Humans ; Hypoglycemic Agents/therapeutic use ; Insulin/diagnostic use ; *Insulin Resistance ; Male ; Middle Aged ; Thiazolidinediones/*therapeutic use

OBJECTIVES: We investigated the association of Val108/158Met polymorphism on catechol-O-methyl transferase(COMT) gene with smooth pursuit eye movement(SPEM) abnormality in Korean schizophrenia patients. METHODS: We measured SPEM in 217 Korean schizophrenia patients(male 116, female 101) and divided them into two groups, one was a good SPEM function group and the other was a poor SPEM function group. Then we analyzed Val108/158Met polymorphism on COMT gene. We compared the differences of genotype and allele distributions of the polymorphism on COMT gene between the two groups. RESULTS: The natural logarithm value of signal/noise ratio(Ln S/N ratio) of the good SPEM function group was 4.39+/-0.33(mean+/-s.d.) and that of poor SPEM function group was 3.17+/-0.71. There were no statistically significant differences of age and male/female ratio between the two groups. There were no significant differences of genotype or allele distributions of the Val108/158Met polymorphism on COMT gene between the two schizophrenic groups. CONCLUSIONS: The results suggest that Val108/158Met polymorphism on COMT gene is not related to SPEM function abnormality in schizophrenia.
Alleles ; Eye ; Female ; Genotype ; Humans ; Polymorphism, Genetic ; Pursuit, Smooth ; Schizophrenia

OBJECTIVE: We investigated the association of P1635 and P1655 polymorphisms on dystrobrevin binding protein 1 (DTNBP1) gene with smooth pursuit eye movement (SPEM) abnormality in Korean schizophrenia patients. METHODS: We measured SPEM function in 216 Korean schizophrenia patients (male 116, female 100) and divided them into two groups, one is a good SPEM function group and the other is a poor SPEM function group. We then analyzed P1635 polymorphism and P1655 polymorphism on DTNBP1 gene from their DNAs extracted from their blood. We compared the differences of genotype and allele distributions of the two polymorphisms on DTNBP1 gene between the two groups. RESULTS: The Ln S/N ratio (mean+/-sd) of the good SPEM function group was 4.39+/-0.33 and the ratio of poor SPEM function group was 3.18+/-0.71. There were no statistically significant differences of age and male/female ratio between the two groups. There were no significant differences of genotype or allele distributions of the P1635 polymorphism and P1655 polymorphism on DTNBP1 gene between the two schizophrenia groups divided by SPEM function. CONCLUSION: The results suggest that P1635 polymorphism and P1655 polymorphism on DTNBP1 gene might not be related to SPEM function abnormality in schizophrenia.
Female ; Male ; Humans

OBJECTIVES: We investigated the association of SNP A and P1763 polymorphisms on dystrobrevin binding protein 1(DTNBP1) gene with smooth pursuit eye movement(SPEM) abnormality in Korean schizophrenic patients. METHODS: We measured SPEM function in 217 Korean schizophrenics(male 116, female 101) and divided them into two groups, one is a good SPEM function group and the other is a poor SPEM function group. We then analyzed SNP A polymorphism and P1763 polymorphism on DTNBP1 gene from their DNAs extracted from their blood. We compared the differences of genotype and allele distributions of the two polymorphisms on DTNBP1 gene between the two groups. RESULTS: The Ln S/N ratio(mean+/-SD) of the good SPEM function group was 4.39+/-0.33 and the ratio of poor SPEM function group was 3.17+/-0.71. There were no statistically significant differences of age and male/female ratio between the two groups. There were no significant differences of genotype or allele distributions of the SNP A polymorphism and P1763 polymorphism on DTNBP1 gene between the two schizophrenic groups divided by SPEM function. CONCLUSION: The results suggest that SNP A polymorphism and P1763 polymorphism on DTNBP1 gene might not be related to SPEM function abnormality in schizophrenia.
Alleles ; Carrier Proteins* ; DNA ; Female ; Genotype ; Humans ; Polymorphism, Genetic ; Pursuit, Smooth* ; Schizophrenia

BACKGROUND: The purpose of this study was to investigate the clinical and electro physiologic characteristics of patients with multiple accessory pathways. Recently as endocardial mapping has become more and more accurate, multiple accessory pathways which were considered to be rare in the past, have become more commonly reported in patients with Wolff-Parkinson-White syndrome. METHODS: From February 1993 to June 2000, there were a total of 452 patients, who were confirmed to have accessary pathway mediated-tachyarrhythmias diagnosed by electrophysiologic study. Among those, 19 patients had multiple accessory pathways, and were enrolled in this study. RESULTS: Among the 19 patients, thirteen patients were male and six were female, and their mean age was 36.5+/-16.17 years. All patients had 2 accessory pathways. The distribution of the location of the accessory pathways was at the left free wall (71.1%), right free wall (18.4%) and posteroseptal wall (10.5%). The most common combination pattern was the left free wall and left free wall (57.9%) and the most common anatomical areas were the left lateral wall and left posterior wall (36.8%). The success rate of the catheter ablation was 84.2% (16/19). The recurrence rate after the radiofrequency catheter ablation was 31.3% (5/16) and the most common recurrence site was left free wall (60.0%, 3/5). CONCLUSION: These results indicated that the clinical and electrophysiologic characteristics of the multiple accessory pathway patients with WPW syndrome in our study were similar to those of western countries.
Catheter Ablation ; Female ; Humans ; Male ; Recurrence ; Wolff-Parkinson-White Syndrome

OBJECTIVE: Malnutrition and nutritional disorder may cause problem of fertility and therefore adequate nutrition is very important during pregnancy. In this study, we investigated effects of supplemental diet contained folic acid, zinc, calcium, Iron, DHA and taurine on fertility outcome in the female rats and learning ability of their offsprings. METHODS: The female rats at 4 week were fed by two group divided control (AIN-76 diet) and supplement diet. The male rats were taken pellet type diet. After 3 weeks, female rats and male rats were mated. Then, at 3 weeks after mating, parturition was begun. After paturition, sex and birth weight of offsprings were examined for their offsprings. When the offsprings were 3 weeks of age, position reversional test in a water maze was done for 4 weeks. After female rats were fed experimental diet for 4 weeks, their follicle, corpus luteum, corpus albicans, progesterone, estradiol and ovary weight were measured. RESULTS: 22 rats of 30 in supplemental diet group succeeded on parturition, and 11 rats of 30 in control group succeeded. Pregnancy outcome was fine in both group. There was no significant difference in weight of major bowels and femur length of their offspring. The position reversional test of offsprings in a water maze showed a significant difference between control group and supplement group. Elapsed time and errorneous response to reach the escape platform were significantly lowered in supplemental group than control group. CONCLUSION: This result suggest that supplementation contained folic acid, multivitamins, DHA and taurine may increase fertility rate in the maternal rats and also learning ability in offsprings.
Animals ; Birth Rate* ; Birth Weight ; Calcium ; Child ; Corpus Luteum ; Diet ; Estradiol ; Female ; Femur ; Fertility* ; Folic Acid* ; Humans ; Iron ; Learning* ; Male ; Malnutrition ; Nutrition Disorders ; Ovary ; Parturition ; Pregnancy ; Pregnancy Outcome ; Progesterone ; Rats* ; Taurine ; United Nations ; Zinc

Although calcification of such endocrine gland as adrenal or pineal gland is common, extensive calcification of the pituitary gland is unusual. Calcification is a well recognized but uncommon feature of prolactin-secreting, growth hormone-secreting and non-functioning pituitary tumours. The calcification varies in extent, but rarely exceeds a tiny amount histologically or radiologically. Recently, we had the opportunity to investigate two patients with radiologically demonstrated "pituitary stone" (severely calcified pituitary adenoma). The first Patient, a 51 year-old female, initially presented with general weakness, dizziness, visual disturbance, and loss of hair for 2 months. She was suspected to have a pituitary lesion. Decreased secretion of GH, TSH, LH, and FSH was demonstrated by dynamic tests. On CT scan, she was found to have multilobulated calcified sella mass. She was successfully managed by medical treatment. The second patient, a 65 year-old male, presented with general weakness, nausea, vomiting and polyuria for 2 months. Combined pituitary stimulation test showed subnormal response of GH and prolactine. Radiologic studies revealed pituitary stone which was managed with medical treatment of hormone replacement. We suggest that calcific changes in the pituitary adenoma might be common and occur to the extent of pituitary stone formation with the possible alteration of hormonal secretion.
Aged ; Dizziness ; Endocrine Glands ; Female ; Hair ; Humans ; Male ; Middle Aged ; Nausea ; Pineal Gland ; Pituitary Gland ; Pituitary Neoplasms ; Polyuria ; Prolactin ; Tomography, X-Ray Computed ; Vomiting