Detection and Identification of the Spotted Fever Group Rickettsial Agents from Haemaphysalis Ticks in Jeju Island, Korea

This study investigated the presence of nucleic acids of various Rickettsial agents in ticks collected in Jeju Island, Korea from June 2007 to August 2008, through the nested polymerase chain reaction (PCR) and sequencing analysis of partial citrate synthase (gltA), Rickettsial outer membrane protein B (ompB), and 17-kDa genes. Examination of the 1,584 ticks showed that the subspecies distribution of Haemaphysalis longicornis was 99.81% (n=1,581) and H. flava was 0.19% (n=3). A total 224 out of 250 pools from one to 15 ticks were found to be positive in ompB-PCR assay (minimal infection rate 141 ticks/1,000 tested). From the positive samples, 26 were analyzed by gltA- and 17-kDa-PCR assays. The nucleotide sequences of the ompB- and gltA-PCR products showed a high degree of similarity with those of the Rickettsia japonica (98.7~99.2% and 98.7~99.3%, n=25) and R. monacensis (99% and 99.7%, n=1). However, analysis of the nucleotide sequences of the 17-kDa-PCR amplicons showed that the sequences of the 25 PCR amplicons were more close to R. marmionii (99.4~100%) than R. japonica (98.6~99.1%). These findings suggest that various rickettsial diseases could be transmitted via the bite of tick vectors in Jeju Island, Korea.

Evaluation of Social Nicotine Dependence Using the Kano Test for Social Nicotine Dependence (KTSND-K) Questionnaire in Korea / 결핵및호흡기질환

BACKGROUND: Smoking is one of the most important leading causes of morbidity and mortality. Smoking habit is recognized as nicotine dependence, which consists of physical and psychosocial dependence. To evaluate social nicotine dependence, the Kano Test for Social Nicotine Dependence (KTSND) working group developed a new questionnaire, which consists of 10 questions with a total score of 30 in Japan. We examined the social nicotine dependence among healthy adults using the new KTSND questionnaire and evaluated validity of the KTSND questionnaire in Korea. METHOD: We applied Korean KTSND questionnaire version 2 to employees of hospital, university students and people for medical examination and promotion test. Complete data obtained from the 741 responders were analyzed. RESULT: The mean age of responders was 31.8 years. Among them, males were 57.8%. Current smokers, ex-smokers, and non-smokers were 13.8%, 12.8%, and 73.4% respectively. According to smoking status, the total KTSND scores of current smokers were significantly higher than those of ex-smokers, and of non-smokers (17.1+/-5.4 versus 14.3+/-5.5, and 12.3+/-5.5, p or =4), This finding suggested that the psychosocial dependence might play a different role from physical nicotine dependence in smoking. Most of the non-smokers (62.5%) had an experience of harmful passive smoking especially in public place. CONCLUSION: Our study suggested that the KTSND questionnaire could be a useful method to evaluate psychosocial aspects of smoking.

Validation of the Korean Version of the St. George's Respiratory Questionnaire for Patients with Chronic Respiratory Disease / 결핵및호흡기질환

BACKGROUND: The "health-related quality of life" (HRQL) for patients with chronic respiratory disease has been emphasized, because chronic respiratory disease (CRD) is chronic and progressive, and it finally causes disability. HRQL instruments may be useful for monitoring patients' progress or for determining the most appropriate choice of treatment. We describe the adapting St George's Respiratory Questionnaire (SGRQ), which is a self-administered questionnaire developed by Jones et al. (1991), into the Korean version for covering three domains of health for the patients suffering with airways disease. METHOD: We obtained the original SGRQ from the author after gaining permission. For adaptation, we created an expert panel and translated the original questionnaire into Korean language. The translated questionnaire was then back-translated by bilingual experts and we compared it with the original questionnaire. After correction and feasibility testing, 74 patients with chronic respiratory disease (COPD, asthma, destroyed lung) completed the Korean version of the SGRQ. The clinical status of each patients was evaluated concurrently with measurement of their health status. RESULT: The Korean version of the SGRQ was acceptable and easy to understand. Cronbach's alpha reliability coefficient was 0.92 for the overall scale and 0.63 for the "Symptoms", subscale, 0.87 for the "Activity", subscale, and 0.89 for the "Impacts" subscales. The correlation coefficients between the overall score and the Borg scale score, oxygen saturation, and forced expiratory volume in one second (FEV(1)) were 0.52, -0.32 and -0.26, respectively. These results support that the Korean SGRQ was correlated with other measurements. CONCLUSION: The Korean SGRQ was reliable and valid for patients with chronic respiratory disease, such as COPD, asthma, and destroyed lung. The SGRQ score was well correlated with other respiratory measurements as well. Although further studies should complete the adaptation work, our results suggest that the SGRQ may be used in Korea and also for international studies involving Korean CRD patients.

Two cases of rifampin desensitization in AIDS patients with rifampin hypersensitivity / 천식및알레르기

Adverse reactions to drugs are more common in HIV infected patients. Hypersensitivity to trimethoprim-sulfamethoxazole (TMP/SMZ) during treatment or prophylaxis of Pneumocystis carinii pneumonia (PCP) is the most frequent drug reaction of HIV infection. Although less extensively documented than sulphonamides, other drugs also seem to induce drug reactions in HIV-seropositive patients more than in other groups. Rifampin is an essential anti-tuberculosis medication; thus, desensitization of rifampin is especially necessary in our country in which mycobacterial infection is common. We report two cases of AIDS patients with pulmonary tuberculosis who have rifampin hypersensitivity whose rifampin treatment will end successfully through rifampin desensitization.

A Case of Bronchial Papilloma / 결핵

Bronchial papilloma is a rare disease which most commonly manifests as an epithelial tumor consisting of polypoid interstitial tissues and epithelioid cells. This benign tumor comprises 2-5 % of primary lung tumors and papilloma derived from the bronchial epithelium, and is a rare benign tumor in adults. Bronchial papilloma has a poor prognosis with a high risk of developing a malignancy. We report a case of a bronchial papilloma in a 62-year-old female patient, presenting with hemoptysis and an endobronchial lesion with a brief review of the relevant literature.

A Case of Bronchial Papilloma / 결핵

Bronchial papilloma is a rare disease which most commonly manifests as an epithelial tumor consisting of polypoid interstitial tissues and epithelioid cells. This benign tumor comprises 2-5 % of primary lung tumors and papilloma derived from the bronchial epithelium, and is a rare benign tumor in adults. Bronchial papilloma has a poor prognosis with a high risk of developing a malignancy. We report a case of a bronchial papilloma in a 62-year-old female patient, presenting with hemoptysis and an endobronchial lesion with a brief review of the relevant literature.

A Case of Tracheal Bronchus Associated with Bilateral Superior Vena Cava Anomaly / 결핵

A tracheal bronchus, an aberrant bronchus arising directly from the trachea, is an infrequent congenital anomaly. The incidence of this anomaly ranges from 0.5 to 5%. It usually originates from the right lateral wall of the trachea at the level <2 cm above the tracheal bifurcation. These patients usually are asymptomatic, but some patients may experience recurrent pneumonia, chronic bronchitis, bronchiectasis, or asthmatic episodes. A tracheal bronchus may be associated with other anomalies such as a tracheal stenosis, pulmonary agenesis, pulmonary sequestration, congenital heart disease, a pulmonary venous anomaly and Down's syndrome. This anomaly is usually diagnosed incidentally during bronchoscopy in patients with respiratory problems. Here we report a case of a 20-year-old man with a past history of bronchial asthma, which was incidentally diagnosed as a tracheal bronchus during a medical examination prior to military service, and was associated with a bilateral superior vena cava anomaly.