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Background : Hepatitis C virus (HCV) core antigen (Ag) levels are known to be well correlating with HCV RNA levels, and may be used as an alternative marker of HCV replication for monitoring the response to HCV treatment. However, the low sensitivity of HCV core Ag assay has been an obstacle for clinical use. In this study, recently developed ARCHITECT HCV Ag assay (Abbott Laboratories, USA) was evaluated for analytical performance and clinical usefulness. Methods : A total of 109 sera from HCV infected patients including various genotypes of HCV (1b, 2, 2a/2c, 2b, and 3a) and 20 sera from healthy donors were used for evaluating the sensitivity, precision, and linearity of the HCV core Ag assay. The cross reactivity with HIV, hepatitis B virus and myeloma proteins (N=5, each) and correlation with HCV RNA PCR assay were also evaluated. Results : The sensitivity of the HCV core Ag assay was 97.2% (106/109) and there were no false positive results and cross reactivity. The within-run, between-run and between-day CVs were 3.0%, 2.5% and 3.0%, respectively. The levels of HCV core antigen showed a good correlation with those of HCV RNA quantification (r=0.940). The HCV Ag assay showed an excellent linearity in the range from 0.63 to 17,114 fmol/L (r=0.999). Conclusions : The ARCHITECT HCV Ag assay was good in sensitivity, precision, and linearity and its results well correlated with HCV RNA levels. This assay could be used as a good marker of viral replication for monitoring the therapy response in chronically HCV infected patients. (Korean J Lab Med 2010;30:654-9)

Hypermethylation of the homeobox (HOX) gene promoter leads to decreased expression of the gene during tumor development and is thought to be correlated with the clinical outcome in leukemia. In this study, we performed pyrosequencing to quantify the methylation level of HOXA5 genes in the bone marrow samples obtained from 50 patients with AML and 19 normal controls. The methylation percentage of HOXA5 in AML patients (median=65.4%, interquartile range=35.9-72.3%) was higher than that of HOXA5 in control patients (median=43.1%, interquartile range=36.7-49.6%, Mann-Whitney U test, P=0.012). The patients of the AML group who had a high methylation percentage (>70%) had a good prognosis with a 3-yr overall survival (OS) of 82.5%, whereas the patients with a low methylation percentage (≤70%) showed a 3-yr OS of 40.5% (P=0.048). Cox proportional hazards regression showed that the methylation percentages of HOXA5 were independently associated with the 3-yr OS of AML patients, regardless of their karyotypes. We propose that the quantification of HOXA5 methylation by pyrosequencing may be useful for predicting short-term prognosis in AML. However, the limitations of our study are the small sample size and its preliminary nature. Thus, a larger study should be performed to clearly determine the relationships among HOXA5 methylation levels, cytogenetics, and prognosis in AML patients.

We evaluated high-resolution melting (HRM) curve analysis as a tool for detecting rifampin (RIF) and isoniazid (INH) resistance in Mycobacterium tuberculosis in an accurate, affordable, and rapid manner. Two hundred seventeen M. tuberculosis clinical isolates of known resistance phenotype were used. Twenty-nine known rpoB mutant DNAs, including rare mutations, were also included. Four pairs of primers were designed: rpoB -F/R (for codons 516 to 539 of rpoB ), rpoB -516F/R (for codons 508 to 536 of rpoB ), katG -F/R (for the codon 315 region of katG ), and inhA -F/R (for the nucleotide substitution of C to T at position −15 of inhA ). An HRM curve was generated for each isolate after real-time PCR differentiated the mutant from the wild-type strains. DNA sequencing of the target regions was performed to confirm the results of the HRM curve analysis. All but one of the 73 RIF-resistant (RIF-R) strains and all 124 RIF-susceptible (RIF-S) isolates were correctly identified by HRM curve analysis of rpoB . Twenty-seven of 29 known rpoB mutants were detected. In HRM curve analysis of katG and inhA , 90 INH-R strains that harbored katG or inhA mutations, or both, and all INH-S strains were correctly identified. Ten phenotypically INH-R strains not harboring katG or inhA mutations were not detected. The HRM curve analysis will be a useful method for detection of RIF and INH resistance in M. tuberculosis in a rapid, accurate, simple, and cost-effective manner.

Background : The prostate-specific antigen (PSA) is considered the most useful among tumor markers currently used. However, its quantitative results are interpreted only qualitatively for the diagnosis of prostate cancer. The recently introduced information theory enables the information of the quantitative results transformed into Shannon's entropy (S) that represents uncertainties and then "1-S" representing diagnostic certainty. Methods : The 882 urological patients enrolled were categorized into 2 groups: a patient group comprising 233 patients with prostate cancer and a disease control group comprising 649 patients with benign prostate disease. The level of PSA in all the patients was tested and was found to be ng/mL. The variables like PSA level and age were modeled on logistic regression analysis to predict the probability of prostate cancer and the diagnostic certainty. Results : The mean (SD) of PSA levels in the patient group and the disease control group were 44.5 ng/mL (37.62 ng/mL) and 5.7 ng/mL (3.70 ng/mL), respectively. The logistic regression model fitted well when the age variable was dichotomized at the age of 55 yr. The diagnostic certainty was lowest at a PSA level of 18.90 ng/mL in the 55-yr age group. Conclusions : The diagnostic certainty (1-S) of whether to diagnose prostate cancer or not at a certain PSA level could be obtained using the information theory. The methodology used in this study may help interpret the results of other quantitative tests.

Incompatibility of human leukocyte antigen (HLA) alleles between donors and recipients of unrelated hematopoietic stem cell transplantation (UHSCT) increases the risk of acute graft-versus-host disease (GVHD). We evaluated the positional effect of amino acid substitutions in HLA molecules on severe acute GVHD in Korean pediatric recipients of UHSCT. All of 64 donor-recipient pairs were serologically matched for HLA-A, -B, and -DR loci. Only substitution at residue 9 resulting from an HLA-A*02 polymorphism was significantly associated with the risk of severe acute GVHD in patients (OR=7.0, P=0.033) on multivariate analysis. Recipients of this mismatched HLA also showed shortened overall survival (HR=9.7, P0.001) and increased risk for transplant-related mortality (HR=9.1, P=0.027). Structural modeling showed that the amino acid substitution could alter the peptide preference of the ligand-binding pocket. A single amino acid substitution at position 9 was a major predictor of severe acute GVHD in Korean pediatric patients.

The Beijing family of Mycobacterium tuberculosis has been emerging in the world. However, there are few nationwide data of genotypic distribution in Korea. This study aimed to identify the genotypic diversity of clinical isolates of M. tuberculosis and to demonstrate the population of Beijing family in Korea. We collected 96 clinical M. tuberculosis isolates from 11 university hospitals nationwide in Korea from 2008 to 2009. We observed 24 clusters in IS6110-RFLP analysis and 19 patterns in spoligotyping. Seventy-five isolates were confirmed to be Beijing family. Two isolates of the K strain and 12 isolates of the K family strain were also found. We found that drug resistance phenotypes were more strongly associated with Beijing family than non-Beijing family (P=0.003). This study gives an overview of the distribution of genotypes of M. tuberculosis in Korea. These findings indicate that we have to pay more attention to control of M. tuberculosis strains associated with the Beijing family.

Kinematic and kinetic studies have been reported numerously to estimate the dynamic efforts over upper extremity joints during manual wheelchair propulsion. In this study, Joint angles, EMGs and wheelchair axle torque during manual wheelchair propulsion with different external loads were investigated. Four healthy males were volunteered for this study and their motions were analyzed when they propelled the wheelchair. Three dimensional motion data were collected through the motion capture system and also, the signals from the wheelchair dynamometer and the EMG device were recorded synchronized with the motion system. Shoulder, elbow and wrist joint angles and trunk angle were derived from the motion capture system. Propulsion time was increased as the resistance was increased. The wrist, elbow and shoulder joint angles during the contact phase were not different significantly as the resistance increased. The peak torque of wheelchair axle during propulsion was not different significantly between 10 and 15kg resistance. However, the trunk flexion angle and momentum were observed largely increased when the resistance increased. The increased resistance in wheelchair propulsion could be assumed as the increased slope. When the resistance or slope is high, propulsion torques increased but EMG activities were not increased proportional to the resistance. Propulsion time and recovery speed were increased when the resistance was increased. Moreover, trunk flexion allowed the larger downward momentum and it may enhance the propulsion efficiency.

Summary This article describes the clinical observation of a novel hemoglobin (Hb) variant found during the course of routine blood testing on a 61-year-old subject. The Hb variant was observed during HbA1c testing by ion-exchange high-performance liquid chromatography. Alkaline electrophoresis and DNA sequencing confirmed the presence of a new Hb variant, HBB:c.407C > A (p.Ala136Asp). This mutation has been reported to induce Hb Beckman variant in the Globin Gene Server. However, it was different from the only experimental report for Hb Beckman by Rahbar, Lee & Asmeron (p.Ala136Glu; Hb Beckman alpha2 beta2 135(H13) ala-to-glu: a new unstable variant and reduced oxygen affinity. Blood 78, 204a). And our case was asymptomatic with normal lab findings, while Rahbar et al.’s case showed the clinical manifestations of chronic anemia. This would be a report for a novel Hb variant suggesting new insight of Hb Beckman variant. This would be a report of a novel Hb variant suggesting new insights into Hb Beckman variant.

In this paper, CMOS millimeter-wave power amplifiers operating at Q-band (40 GHz) and Ka-band (27 GHz) are presented. The Q-band amplifier was designed using 0.13 mum standard CMOS process having 6 layers of copper metallization, and the amplifier resulted in a small-signal gain of 9.3 dB at 40 GHz when biased at IDS = 53 mA and VDS = 1.5 V. The Ka-band amplifier was design using 0.18 mum RF CMOS process. The amplifier showed a small-signal gain of 14.5 dB at 27 GHz when biased at IDS = 94 mA and VDS = 1.8 V. The results show the potential of CMOS millimeter-wave system-on-chip (SoC) at frequencies greater than 20 GHz.

Although hepatitis B surface antigen (HBsAg) rapid test based on immunochromatographic assay (ICA) is now widely used, the test has not been evaluated sufficiently enough to validate its performance. Thus, it is important to summarize the clinical performance of the test kits. In this study, we performed meta-analysis for the performance of the HBsAg rapid tests.PubMed database was searched using keywords about the accuracy of diagnostic tests for hepatitis B virus (HBV) infection. Two investigators assessed methodological quality utilizing standards for reporting of diagnostic accuracy studies (STARD) checklist. After performing a heterogeneity test, we obtained pooled sensitivity and specificity. Positive and negative predictive values (PPV and NPV) were simulated according to HBV prevalence.A total of 38 studies was selected from 10 papers. The quality scores ranged from 3 to 13 (median, 8). Kappa value was good (0.85). The performance of the 38 studies was heterogeneous. When 33 studies with better quality from 7 papers were re-selected, the pooled sensitivity and specificity were 98.07% (95% confidence interval, CI: 97.67-98.47%) and 99.56% (95% CI: 99.21-99.91%), respectively. With an HBV prevalence of 5%, PPV and NPV were predicted to be 92.14% and 99.90%, respectively.In view of high HBV prevalence in Korea, it is thought that the HBsAg rapid test can be used for HBV screening in small-sized laboratories or for epidemiologic studies. This study should be helpful in establishing a guideline for the proper performance evaluation of the HBsAg rapid tests.

BACKGROUND PCR is a widely used method for rapid and accurate diagnosis of mycobacteriosis. The sensitivity and specificity of a real time PCR kit newly developed in Korea were evaluated for detecting mycobacteria in respiratory specimens. METHODS One hundred twenty nine Mycobacterium tuberculosis (TB) culture positive respiratory specimens (82 AFB stain positive and 47 stain negative specimens) were used for evaluation of the sensitivity. Nine non-tuberculous mycobacteria (NTM) culture positive specimens were also included. For evaluation of the specificity, 48 AFB stain and culture negative respiratory specimens from patients who were initially not fully excluded from mycobacterial diseases (specificity group 1) were used. Other 51 respiratory specimens from patients who were not suspected of mycobacterial diseases were also included (specificity group 2). Real time PCR was performed by using AdvanSure TB/NTM real time PCR Kit (LG Lifescience, Korea) and SLAN real time PCR detection system (LG Lifescience). The target genes of TB and NTM were IS6110 and rpoB, respectively. RESULTS Among 129 TB culture positive specimens, 82 of 82 AFB stain positive specimens (100%) and 35 of 47 (74.5%) stain negative specimens revealed real time PCR positivity for TB, resulting in sensitivity of 90.7%. Five of nine NTM culture positive specimens resulted in real time PCR positivity for NTM (55.6%). Forty seven of 48 specimens (97.9%) and all 51 specimens (100%) of the specificity group 1 and 2, respectively, were real time PCR negative for TB and NTM. CONCLUSIONS AdvanSure TB/NTM real time PCR Kit should be useful for detecting TB in respiratory specimens with high sensitivity and specificity.

A 26-year-old man who had a history of recurrent spontaneous nasal bleeding was admitted to our hospital with uncontrolled traumatic subdural hemorrhage. His plasma factor VII activity was less than 10% of normal. DNA sequence analysis revealed that the proband had a compound heterozygote for a novel nonsense mutation (F7 NM_000131.2 c.345C > A; p.Cys115X) in exon 4 encoding the EGF1 domain and a known missense mutation (F7 NM_000131.2 c.1027G > A; p.Gly343Ser) in exon 8 encoding the serine protease domain of F7. The same F7 Gly343Ser mutation was present in the asymptomatic father, who exhibited a modest reduction in the plasma level of factor VII activity (48%).

eISSN 2093-6338 최근 CMV와 EBV에 대한 예방적 또는 선제적 항바이러스제 치료 가 증가하면서, 모니터링 검사로서 CMV, EBV DNA 정량을 위한 실 시간 PCR (quantitative real-time PCR, qPCR) 검사법이 보편화되었 다[3, 4]. CMV, EBV qPCR 검사는 Conformite Europeenne (CE) 또 는 미국 식품의약품안전처(U.S. Food and Drug Administration, FDA) 승인을 얻은 검사법들이 이용 가능하다[5-7]. 또한 CMV qPCR 검사 키트들은 2010년 WHO가 제작하여 시판하는 국제 표 준물질(NIBSC code: 09/162)을 기준으로 보정(calibration)되었기 때문에, “IU/mL” 또는 “log10 copies/mL” 단위로 보고 가능하다[8]. EBV qPCR 검사도 2011년부터 WHO 표준물질(NIBSC code: 09/260)의 이용이 가능해졌다[9]. 이와 같이 CMV, EBV qPCR 검사법들의 표준화는 많이 이루어졌 지만, qPCR 검사를 위한 핵산 추출법에 대해서는 표준화된 가이 드라인이 없는 실정이다[10]. College of American Pathologists (CAP)는 qPCR의 경우 내부대조물질(internal control)을 핵산 추출 서 론

Restriction fragment mass polymorphism (RFMP) was applied to pooled DNA for selecting informative single nucleotide polymorphisms (SNPs). A total of 225 coding non-synonymous SNPs (cnSNPs) from immunomodulating genes known to be involved in the pathogenesis of asthma were selected from the National Center for Biotechnology Information's (NCBI) SNP database (dbSNP). DNA samples from 200 healthy Koreans were pooled, amplified by polymerase chain reaction, digested with restriction enzymes and the fragments analysed by mass spectrometry. Only 30 of the 225 cnSNPs (13.3%) were informative, i.e. had a minor allele frequency > 10%. The percentage of informative cnSNPs varied according to the validation status of the dbSNP, being 42.3% (22/52) when validated by multiple submissions and frequency data, 8.7% (2/23) when validated by multiple submissions alone and 9.1% (3/33) when validated by frequency data alone. Most of the 112 unvalidated cnSNPs were not informative. In conclusion, the RFMP method using pooled DNA is useful in selecting informative SNPs, as also is validation status in the dbSNP.

Generalized low bone mass and osteopenia in both axial and peripheral skeleton in adolescent idiopathic scoliosis (AIS) have been reported in literature. However, the exact mechanisms and causes of the bone loss in AIS are not identified yet. Therefore, this study examined the relationship between serum concentration of soluble receptor activator of nuclear factor-kappaB ligand (RANKL), serum level of osteoprotegerin (OPG) and bone mass in 72 patients with AIS and compared to those of 64 age- and gender-matched healthy controls. The mean lumbar spinal bone mineral density (LSBMD) and femoral neck BMD (FNBMD) in patients with AIS were decreased compared with that in control individuals, respectively (P = 0.0029 and P = 0.0192, respectively). The mean RANKL and RANKL to OPG ratio in patients with AIS were increased compared with that in control subjects, respectively (P = 0.0004 and P = 0.0032, respectively). The RANKL and RANKL to OPG ratios were negatively correlated to the LSBMD and serum OPG levels in both groups. Serum OPG levels were positively correlated to the LSBMD and FNBMD in both groups. These findings mean that the imbalance and the disturbed interaction of RANKL and OPG may be an important cause and pathogenesis in reduced BMD in AIS.

Ensuring stability is one of the most important themes of humanoid robot, because humanoid robot inherently suffers from instability. And the stable landing is the first step in various environments for the stable walking. However, it is difficult to obtain ground information in landing. So, we propose the stable walking of humanoid robot by using landing control in various environments. Landing control needs to satisfy constraints of dynamic stability, ground conditions and various feet motions to fit the each case in various environments. In most of the previous researches on landing control, robot equips foot with special mechanical equipments to obtain environment conditions. However in this paper, the various environments can be recognized with only FSRs (Force Sensing Resistors). The proposed method is evaluated through walking on an ascent with a 19 DOF (Degree of Freedom) biped robot model.

In this paper, a new methodology for medical diagnosis based on fuzzy clustering and parallel neural networks is proposed. Intelligent systems have various fields. Breast cancer is one of field to be targeted, which is the most common tumor-related disease among women. Diagnosis of breast cancer is not task for medical expert owing to many attributes of the disease. So we proposed a new method, FCM based parallel neural networks to handle difficult. FCM based parallel neural networks composed of two parts. One is classifying breast cancer data using Fuzzy c-means clustering method (FCM). The other is designing the multiple neural networks using classified data by FCM. The proposed methodology is experimented, evaluated, and compared the performance with other existed models. As a result we can show the effectiveness and precision of the proposed method are better than other previous models.

The paper describes a response surface methodology (RSM) as an efficient approach to parametric model building and design optimization. Design optimization is a critical important step in the design and evaluation of BLAC motors. The objective in design optimization is to search the design space to determine the values of design variables that optimize the performance characteristics subject to system constrains.

Driven by customer's demand, small sized mobile phones are realized due to latest development in electronics. For acoustic parts such as microspeakers and dynamic receivers, however, size reduction is relatively difficult due to their mechanical characteristics. An integrated device (microspeaker and dynamic receiver within one structure) has been developed to realize efficient size reduction. In this paper, a systematic analysis of magnetic field and acoustic characteristic is performed using finite element method (FEM) analysis. The analysis includes magnetic field analysis, vibration analysis and acoustic analysis.

In motor applications, noise and vibration reduction techniques should be implemented in its design stage for improved performance. Motor vibration is mainly induced from stator, especially from teeth excited by electromagnetic force. In this paper, to provide a useful noise reduction technique, electromagnetic force acting on a motor tooth is analyzed as an acoustic noise source and the result is verified by noise measurement.

Whole blood levels 2 hours after Neoral (C 2 ) administration were observed to correlate better with area under the curve (AUC 0–4 ) than trough levels (C 0 ), suggesting that C 2 may be the best single time point predictor of Neoral absorption. Owing to concerns about drug toxicity due to excessive immunosuppression, C 2 adjustments to target blood levels may represent an advance. The present study measured C 2 and levels to determine which correlated more closely with AUC 0–4 . Methods Between August 2003 and July 2004, 40 adult liver transplantations were performed in our center. All patients received Neoral twice daily. They were maintained at a C 0 level of about 200 ng/mL. C 0 levels were measured daily. C 2 levels were estimated on postoperative days 3, 5, 7, 14, and 28. AUC 0–4 performed on postoperative days 3, 7, and 28 was calculated using the trapezoidal rule. Results The mean AUC 0–4 , C 0 , C 1 , C 2 , C 3 , and C 4 were 1100.3 ± 484.8 ng/mL, 197.1 ± 84.7 ng/mL, 240.7 ± 166.2 ng/mL, 307.8 ± 162.6 ng/mL, 302.8 ± 138.9 ng/mL, and 300.3 ± 142.8 ng/mL, respectively. C 2 correlated with AUC 0–4 ( R 2 = 0.868: P 0 ( R 2 = 0.245: P 1 ( R 2 = 0.604: P 4 ( R 2 = 0.583: P Conclusions Neoral dose monitoring according to a mean C 2 range of 307.8 ± 162.6 ng/mL correlated better with AUC 0–4 . Further studies are required to determine suitable C 2 levels in liver transplant patients.

In this report, we describe the identification of a human leucocyte antigen-A*11 (HLA-A*11) nucleotide sequence variant, a new HLA-A*1120 by using sequence-based typing (SBT). The new allele was detected during routine HLA typing by high-resolution SBT. Allele A*1120 showed one nucleotide difference with A*110101 at codon 152 (GCG-->GAG) resulting in an amino acid change from alanine to glutamate. Residue 152 is located on alpha(2)-helix of HLA class I molecule and involved in peptide binding by constructing E pocket of peptide-binding groove, implying that the change of the residue 152 would affect the binding affinity of peptides to A*1120 allele.

In this report, we describe the identification of an HLA-A*31 nucleotide sequence variant, a new HLA-A*3111, in three members of a Korean family by using sequence-based typing (SBT). The new allele was detected during routine HLA typing by high-resolution SBT. Allele A*3111 showed one nucleotide difference with A*310102 at codon 165 (GTG--CTG) resulting in an amino acid change from valine to leucine (V165L). Serologic reactivity was shorter than normally expected.

We devised a hepatic vein clamping method to assess the amount of hepatic venous congestion (HVC) before liver transection. From February 2003 to May 2003, this method was applied to 5 of 58 living donor livers especially to assess donor safety. The left portal vein and proper hepatic artery as well as the middle hepatic vein (MHV)-left hepatic vein (LHV) trunk were clamped simultaneously to assess the HVC in the remnant right lobe before performing extended left lobectomy. As three donors demonstrated the extent of the HVC equivalent to about 40% of the right lobe volume (RLV), their operations proceeded according to the preoperative plan. The territory of HVC after liver transection was the same as that observed with direct clamping of the hepatic vein. However, one donor showed massive HVC more than 50% of RLV and the operative plan was adjusted to harvest only the left lobe without the MHV trunk for donor safety. To assess the HVC in the remnant left lobe, the isolated LHV trunk was occluded after clamping the donor's proper hepatic artery. The whole left lobe except for a small area at the anterior portion of the medial segment became discolored on LHV clamping: the opposite demarcation appeared on MHV clamping. The amount of HVC was so small that we harvested the right lobe with the MHV trunk. All donors and recipients recovered uneventfully. We believe that this direct clamping method makes the assessment of HVC feasible before parenchymal transection of a donor liver.

ASSESSMENT OF GRAFT SIZE is an essential step for living donor liver transplantation (LDLT). Preoperative evaluation by computed tomogram (CT) or magnetic resonance volumetry of living donor livers has been a routine procedure for matching graft sizes. Liver grafts are also weighed at the back table during the operation. At this time, there is usually a significant discrepancy between the graft volume from preoperative volumetry (volumetric graft volume) and the real graft weight. This difference can be caused by inaccurate volumetric measurement from improper CT images with some respiratory movement; its possibility cannot be negligible because even high-speed CT machines require breath-holding of about 20 seconds. Another possible cause can be the differences between the measurement plane of liver parenchyma used for volumetry and the real transection plane of the liver. However, neither the exact parenchymal transection along the preoperative measurement plane nor the repeated measurement of volumetry along the real transection plane after donor operation makes the volumetric graft volume exactly match the graft weight. Another possible cause is blood content itself in the graft, in which the graft weight measured at the back table is usually blood-free. We have measured the amount of blood in the grafts and analyzed the correlation between volumetric graft volume and graft weight. This observation may serve as an interchangeable bridge over blood-free graft weight and blood-filled graft volume.

In this report, we describe the identification of an human leucocyte antigen-Cw*0102 (HLA-Cw*0102) nucleotide sequence variant, a new HLA-Cw*010203, in a case - control study by using sequence-based typing. Allele HLA-Cw*010203 showed one nucleotide difference with HLA-Cw*010201 by a silent substitution at codon 130 (CTG-->CTA).

In this report, we describe the identification of an human leucocyte antigen-Cw*06 (HLA-Cw*06) nucleotide sequence variant, a new HLA-Cw*0612. The new allele was detected during routine HLA typing by high-resolution sequence-based typing. Allele Cw*0612 showed one nucleotide difference with Cw*0602 at codon 153 (GCG-->ACG) resulting in an amino acid change from alanine to threonine.

In 2005, a group of mycolic acid-containing bacteria was characterized as belonging to a novel genus, Segniliparus with species Segniliparus rugosus and S. rotundus. We report a case of the S. rugosus isolated from a 54-year-old woman with radiologic features mimicking that of non-tuberculous mycobacteriosis (NTM). When the patient first visited our hospital, an acid-fast bacteria (AFB) smear tested positive and Mycobacterium tuberculosis polymerase chain reaction (TB PCR) was negative in the bronchoalveolar lavage sample. After 2 months, the growing colonies were reported as NTM, but could not be identified because they had died. One year after the initial visit, induced sputum samples showed the same results, positive AFB smear and negative TB PCR. At this point, the growing colonies were identified as S. rugosus. Therefore, we should consider Segniliparus genus as a differential diagnosis for AFB in respiratory specimens in addition to the genus Mycobacterium.

Background Positron emission tomography imaging of lung cancers with 2-[fluorine-18]-fluoro-2-deoxy-D-glucose is a non-invasive diagnostic, and prognostic tool that measures tumor metabolism. We have analyzed the effect of solute carrier family 2 (facilitated glucose transporter), member 1 polymorphisms on 2-[fluorine-18]-fluoro-2-deoxy-D-glucose-uptake with a combination of polymorphisms of hypoxia-inducible factor 1 alpha, apurinic/apyimidinic endonuclease, and vascular endothelial growth factor A in a hypoxia-related pathway. Methods We investigated the association between solute carrier family 2 (facilitated glucose transporter), member 1 -2841A>T, hypoxia-inducible factor 1 alpha Pro582Ser, Ala588Thr, apurinic/apyimidinic endonuclease Asp148Glu, or vascular endothelial growth factor A +936C>T and 2-[fluorine-18]-fluoro-2-deoxy-D-glucose-uptake among 154 patients with non-small-cell lung cancer. Results The solute carrier family 2 (facilitated glucose transporter), member 1 -2841A>T polymorphism was significantly associated with 2-[fluorine-18]-fluoro-2-deoxy-D-glucose-uptake in combination with the apurinic/apyimidinic endonuclease Asp148Glu (T>G) polymorphism in the squamous cell type of non-small-cell lung cancer. The solute carrier family 2 (facilitated glucose transporter), member 1 TT genotype had a higher maximum standardized uptake values than the AA + AT genotype when the apurinic/apyimidinic endonuclease genotype was TT (mean maximum standardized uptake values, 12.47 ± 1.33 versus 8.46 ± 2.90, respectively; P = 0.028). The mean maximum standardized uptake values were not statistically different with respect to vascular endothelial growth factor A and hypoxia-inducible factor 1 alpha polymorphisms. Conclusion A glucose transporter gene polymorphism was shown to be statistically associated with glucose-uptake when the apurinic/apyimidinic endonuclease genotype is TT in patients with the squamous cell type of non-small-cell lung cancer. Our findings suggest that a newly developed tracer for positron emission tomography could be affected by genetic polymorphisms.

연구배경: CXCR3 리간드인 케모카인 CXCL10과 CXCL11은 세포면역 활성 시 interferon-γ에 의해 발현이 유도되어, T 림프구와 자연살생세포의 소집 및 활성도를 증가시키고 폐 감염 시 활성화된 기관지 상피 세포에서도 발현된다. 이에 저자들은 세포면역을 활성화 시킬 수 있는 폐암과 결핵감염에서의 CXCL11의 표현을 CXCL10과 함께 정량적으로 비교하여 활동성 결핵감염의 표지자로서 활용 가능성을 알아보고자 하였다. 방법: 2007년 1월부터 12월까지 부산대학교병원 호흡기 내과를 방문한 신규환자 중 폐암과 결핵이 의심되는 환자를 대상으로 전향적 연구를 시행하였다. 환자는 조직학적 그리고 임상적으로 47명의 폐암군, 18명의 활동성 폐결핵군, 그리고 대조군으로 38명의 양성폐질환군으로 분류하였다. 혈청에서 CXCL10과 CXCL11의 농도는 효소 면역측정법을 이용하여 측정하였다. 결과: CXCL10과 CXCL11은 활동성 폐결핵군에서 폐암군과 양성폐질환군에 비해 유의하게 증가되었다(p＜0.001, Kruskal-Wallis). CXCL11은 폐암군이 양성 폐질환군에 비해 유의하게 높았으나, CXCL10은 차이가 없었다(각각, p＜0.001, p=0.655, Mann-Whitney U). 폐암군에서 CXCL10은 stage III+IV군에서 stage I+II군에 비해 높았지만, CXCL11은 병기에 따른 유의한 차이를 보이지 않았다(p＜0.001, p=0.07, Mann-Whitney U). 폐암의 전이 유무에서는 CXCL10과 CXCL11 모두 유의한 차이를 보이지 않았다. CXCL10과 CXCL11간에는 서로 유의한 상관 관계가 있었다(r=0.223, p＜0.001). 결론: CXCL10과 CXCL11은 폐암을 포함한 타 폐질환에 비해 활동성 폐결핵에서 유의하게 증가되었다. 따라서, 활동성 폐결핵에 기존의 진단법과 함께 유용한 지표로서 사용될 수 있을 것이다.

Background: The purposes of the current study were to evaluate the concordant rates of anti-mycobacterial drug susceptibility test (DST) results in different solid media performed in different institutes, and to determine reliable susceptible testing methods. Methods: One hundred and twenty two Mycobacterium tuberculosis strains were isolated from patients in A Hospital in 2005. DSTs were performed by the absolute concentration method using Lowenstein Jensen medium in both A Hospital (method A-1) and B Institute (method B-1) and by the proportion method using Middlebrook 7H10 agar in B Institute (method B-2). Nine drugs were used including isoniazid and rifampin. Sensitivity and specificity of each method were estimated by using the acceptable standard of 90% for isoniazid and rifampin and 80% for other drugs. The therapeutic outcomes of quinolone-administered patients were evaluated according to ofloxacin susceptibility results. Results: Method B-1 showed sensitivity and specificity levels over the acceptable standard levels for all drugs. Method B-2 showed specificity lower than the acceptable levels for rifampin and cycloserine. Method A-1 showed specificity lower than the acceptable levels for isoniazid, streptomycin, p-aminosalicylic acid, and ofloxacin and sensitivity lower than the acceptable levels for prothionamide and cycloserine. The concordance rates of therapeutic outcomes with method B-1, method B-2, and method A-1 were 77%, 74%, and 65%, respectively. Conclusion: The drug susceptibility results for some drugs were discordant between the testing laboratories and media, requiring an urgent application of quality control programs to raise the reliability of anti-mycobacterial DST. (Korean J Clin Microbiol 2008; 11:43-48)