The Prevalence of Toxocariasis and Diagnostic Value of Serologic Tests in Asymptomatic Korean Adults

PURPOSE: Toxocariasis is the most common cause of peripheral blood eosinophilia in Korea and produces eosinophilic infiltration in various organs, including the lung. However, the prevalence of toxocariasis in the general population is rarely reported. METHODS: We investigated the seroprevalence of Toxocara larval antibody among asymptomatic people who attended Samsung Medical Center for a health checkup, including low-dose chest computed tomography (CT) between March 2012 and December 2013. A total of 633 people (400 men and 233 women) were prospectively recruited. RESULTS: The Toxocara-seropositive rate was 51.2% using the current cutoff value based on Toxocara enzyme-linked immunosorbent assay (ELISA) (67.0% for men and 24.0% for women). In the multivariate-adjusted model, age (odds ratio [OR], 1.08; 95% confidence intervals [CI], 1.04-1.11), male sex (OR, 3.47; 95% CI, 2.26-5.33), rural residence (OR, 1.55; 95% CI, 1.05-2.30), and history of raw liver intake (OR, 8.52; 95% CI, 3.61-20.11) were significantly associated with Toxocara seropositivity. When subjects were divided into 3 groups using cutoff values base on weak positive and strong positive control optical densities (ODs), the ORs for peripheral blood eosinophilia and serum hyperIgEaemia were 0.31 (95% CI, 0.02-2.89) in the weakpositive group and 36.64 (95% CI, 11.73-111.42) in the strong positive group compared to the seronegative group. Similarly, ORs for the solid nodule with surrounding halo were 2.54 (95% CI, 0.60-10.84) in the weak positive group and 15.08 (95 CI 4.09-55.56) in the strong positive group compared to the seronegative group. CONCLUSIONS: The study indicated that the Toxocara-seropositive rate obtained by using the current cutoff value based on ELISA was high in the asymptomatic population in Korea. The results of this study suggest that active toxocariasis may be more frequently seen in the Toxocara-strong positive group than in the Toxocara-weak positive group.

Differential Expression of PKD2-Associated Genes in Autosomal Dominant Polycystic Kidney Disease

Autosomal dominant polycystic kidney disease (ADPKD) is characterized by formation of multiple fluid-filled cysts that expand over time and destroy renal architecture. The proteins encoded by the PKD1 and PKD2 genes, mutations in which account for nearly all cases of ADPKD, may help guard against cystogenesis. Previously developed mouse models of PKD1 and PKD2 demonstrated an embryonic lethal phenotype and massive cyst formation in the kidney, indicating that PKD1 and PKD2 probably play important roles during normal renal tubular development. However, their precise role in development and the cellular mechanisms of cyst formation induced by PKD1 and PKD2 mutations are not fully understood. To address this question, we presently created Pkd2 knockout and PKD2 transgenic mouse embryo fibroblasts. We used a mouse oligonucleotide microarray to identify messenger RNAs whose expression was altered by the overexpression of the PKD2 or knockout of the Pkd2. The majority of identified mutations was involved in critical biological processes, such as metabolism, transcription, cell adhesion, cell cycle, and signal transduction. Herein, we confirmed differential expressions of several genes including aquaporin-1, according to different PKD2 expression levels in ADPKD mouse models, through microarray analysis. These data may be helpful in PKD2-related mechanisms of ADPKD pathogenesis.

Expression Profiles of Mutant PKD2 Gene Overexpression in HEK 293 Cells / 대한신장학회잡지

BACKGROUND: PKD2 gene, encoding polycystin-2 protein is a cause of autosomal dominant polycystic kidney disease (ADPKD) forms cyst in the kidney, liver, and pancreas and result cardiac defects. Polycystin-2 protein interacts with polycystin-1 to produce calcium-permeable non-selective cation current but this signaling pathway was unknown well. To identify expression profiles of mutant PKD2 gene overexpressed HEK 293 cells and EF-hand motif function, we execute microarray experiment using mutant (m1, m1/m2) PKD2 overexpressed cells. METHODS: cDNA probes were prepared by labeling mRNA from mutant (m1, m1/m2) PKD2 overexpressed cells with Cy5-dUTP and Cy3-dUTP through reverse transcription. The mixed probes of each sample were then hybridized with 14, 080 cDNA microarray, and the fluorescent signals were scanned by Arraywox scanner (Applied Precision LLC. Northeastern, USA). The values of Cy5-dUTP and Cy3- dUTP on each spot were analyzed and calculated by ImaGene 5.1 software (BioDiscovery Inc., El Segundo, CA, USA). Normalization was performed by using subtract mean and all genes. RESULTS: It PKD2 over-expressed cells, up-regulated genes were 11 containing PTK2 and down-regulated genes were 27 including MAP2, ABS. In mutant (m1) PKD2 genes, up-regulated genes were 20 and down-regulated genes were 121. In mutant (m1/m2) PKD2 genes, up-regulated genes were 363 and down-regulated genes were 360, respectively. Based on the clustering data, up-regulated genes were 5 containing IL4R and SIL1, and down-regulated genes were 6 including SAE1 and CPSF4. CONCLUSION: Microarray analysis may provide invaluable information on the role of mutant PKD2 gene product. In this study, we have used a high-density cDNA microarray technique to assess the gene expression profile of mutant (m1, m1/m2) PKD2 overexpression cells. Value of up- and down-regulated genes normalized by Genesight 3.2 version software compared with M/A plot data to identify confidence of data. Selected genes numbers were different, but the level of fold value was similar. Finally, we identified that several genes maybe involve in PKD2 function.

Genome Mapping of an Extreme Thermophile, Thermus caldophilus GK24

Genome of an extreme thermophile, Thermus caldophilus GK24 has been analyzed to construct the genomic map. The genomic DNAs encapsulated in agarose gel were digested with SspI, EcoRI, SpeI, and HpaI restriction endonucleases, and then the resulting genomic DNA fragments were analyzed by pulsed-field gel electrophoresis. Its restriction map has been constructed by analyzing sizes of the restriction fragments obtained from both complete and partial digestions. The circular form of its genome was composed of about 1.98 Mbp and a megaplasmid. The genomic loci for the genes of xylose isomerase, thioredoxin, tRNA-16S rRNA, 23S rRNA, L5 ribosomal protein, ADP-glucose pyrophosphorylase, DNA-ligase, and Tca DNA polymerase were determined by both Southern hybridization and PCR.

A Case of Massive Bleeding in Jejunal Tuberculosis Treated by Transcatheter Embolization / 대한소화기내시경학회지

Common complications of the intestinal tuberculosis are perforation, obstruction, fistulas, and malabsorption. Massive gastrointestinal bleeding is an extremely rare complication of intestinal tuberculosis. Moreover, this may be the first report in the world on transcatheter arterial embolization against the massive bleeding from intestinal tuberculosis patient. We experienced a case of lower gastrointestinal bleeding due to extensive intestinal tuberculosis as massive as vital sign was unstable. Colonoscopy and esophagogastroduodenoscopy did not reveal bleeding focus. Active jejunal bleeding was suspected by technetium99m labelled RBC scintigraphy. Emergency superior mesenteric artery angiography showed active bleeding focus from jejunal branch of artery and transcatheter arterial embolization was tried with microcoil. After embolization, he had no more hematochezia and vital sign became stabilized. On third hospital day, upper endoscopy was done using pediatric colonoscopy and there were multiple circular ulcers on the proximal jejunum but no evidence of mesenteric ischemia. Small bowel tuberculosis should be suspected as a cause of lower gastrointestinal bleeding in case of negative colonoscopy and upper endoscopy. We suggest that the transcatheter embolization could be taken into consideration as a first-line method of treatment for massive bleeding from intestinal tuberculosis before surgical resection.

A Case of Suspected Behcet's Desease Diagnosed by Manifestation of Pulmonary Artery Aneurysm / 결핵

Behcet's disease is a chronic systemic inflammatory disorder with an unknown etiology. It affects many organs and is characterized by recurrent attacks. Pulmonary artery aneurysms occur more frequent in males, and it is o ne of the rare pulmonary complications of Behcet's disease. It has a poor and prognosis, and is also one of the leading causes of death from Behcet's disease. Here we report a case of suspected Behcet's disease diagnosed by a manifestation of a pulmonary artery aneurysm in a 37-year-old woman.

A case of epidermoid cyst of the liver / 대한내과학회지

Congenital solitary nonparasitic cysts of the liver are rare condition in all age groups. Since 1856, only approximately 900 cases having been reported in the world literature. Epidermoid cysts of the liver are extremely rare type of congenital nonparasitic hepatic cysts, characterized by a fibrous wall entirely lined with stratified squamous epithelium, but lacking hair or skin appendages. This condition has yet to be reported in Korea. Because they have a potential for malignant transformation, it is important to totally resect the epidermoid cyst of the liver. Recently, we experienced a case of 44-year-old female patient with epidermoid cyst of the liver, which condition was complicated by a secondary infection. For this patient, an enucleation of entire cyst was performed. Given the rarity of this case, the following is a report of this case and a review of the relevant literature.

A case of idiopathic retroperitoneal fibrosis with chronic renal failure undergoing maintenance hemodialysis / 대한내과학회지

The idiopathic retroperitoneal fibrosis (IRF) is an inflammatory and fibrosing process that can be complicated by periureteral encasement, ureteral obstruction and subsequent chronic renal failure if left untreated. Unfortunately, treatment is often delayed due to the nonspecific nature of the presenting signs and symptoms. The treatment of IRF is controversial. Recently, surgical correction of IRF attempted open surgical treatment or using laparoscopy before severe renal damage.We experienced a case of IRF with chronic renal failure. Serum creatinine on admission was 22.1 mg/dL, and he was treated with percutaneous nephrostomy. Due to uremic symptom and progressive elevated serum creatinine, he was started hemodialysis. We present the case with a review of literature.

A Case of Hypothermia Combined with Systemic Lupus Erythematosus

Systemic lupus erythematosus(SLE) is a prototypic autoimmune disease affecting various organ systems. Hypothermia is a rare manifestation of SLE. We experienced a case of SLE combined with hypothermia. A 36-year-old woman, who had been diagnosed as SLE 3 days before admission, admitted complaining of mental confusion. After admission, her body temperature, initially 36.1 degree C, became 32.6 degree C. Her core body temperature was less than 35.0 degree C. Despite of warming with heating lamp and blankets, her core temperature did not reach 35.0 degree C during 18 hours. Ten days later, her temperature exceeded 36.0 degree C.