Molecular Genetic Typing of Legionella pneumophila Strains Isolated in Jejudo, Korea

Twenty two strains of Legionella species isolated from Jejudo, Korea were identified by comparing the rpoB (300 bp), dotA (360 bp), and mip (396 bp) gene sequence analysis. Furthermore, their genotypes were determined by sequence analysis of rpoB/dotA subgroup typing, pulse-field gel electrophoresis (PFGE) and random amplified polymorphic DNA (RAPD) patterns. Of the 22 isolates, 21 strains were identified as L. pneumophila and 1 strain was close to L. erythra (>95% similarity of rpoB and mip). Most of the L. pneumophila strains (90%) belonged to P-I of rpoB/dotA subgroup typing, one strain of each P-III and P-IV. L. pneumophila isolates were further grouped into 4 and 6 different PFGE (P1 to P4) and RAPD (R1 to R6) patterns, respectively. On the basis of these genotypes, which may be useful for future epidemiological studies, existence of diverse L. pneumophilla population in Jejudo, Korea were observed.

Clinical Analysis of Video-assisted Thoracoscopic Surgery for Spontaneous Pneumothorax: Comparison of Apical Pleurectomy Versus Talc Powder sufflation / 대한흉부외과학회지

BACKGROUND: When compare with blebectomy or bullaectomy simply and pleurodesis together in treatment of primary spontaneous pneumthorax, the later has been realized as the method that can reduce the recurrent rate after surgical operation. Therefore, in this study, we compared the merits and demerits of the clinical result of chemical pleurodesis that use Talcum powder in pleurodesis and mechanical pleurodesis that use apical pleurectomy and analyzed the reappearance rate etc. MATERIAL AND METHOD: The Pleurodesis through the apical pleurectomy and talc powder insufflation had been used as secondary procedure after blebectomy of spontaneous pneumothorax from January 1, 2000 to June 30, 2002. This study consisted of a retrospective review of 68 patients who were treated with apical pleurectomy, and 84 patients treated with talc powder insufflation. We compaired the apical pleurectomy and talc powder insufflation in terms of age, sex, cause of operation, number of used autosuture staple, time duration of procedure after blebectomy, severity of pain and complication after operation, postoperative air leakage period, duration of chest tube insertion, hospitalization, and recurrence rate of pneumothorax. RESULT: Time required for secondary procedure was longer in apical pleurectomy than talc powder insufflation. Postoperative pain was more severe in talc powder insufflation than apical pleurectomy. Otherwise there was no significant difference between two methods. CONCLUSION: Although Talc powder insufflation is more convenient than apical pleurectomy, the difference is not large and, the severity of postoperative pain is worse in talc powder insufflation. Therefore apical pleurectomy can be recommended for the secondary surgical procedure after blebectomy of primary spontaneous pneumothorax can be recommended.

A Case of Gastric Ulcer associated with Mucormycosis / 대한내과학회지

Mucormycosis is an uncommon, frequently fatal, opportunistic fungal infection. Rhino-cerebral and pulmonary involvement are the most common forms and usually occur in immunecompromised patients. Gastrointestinal involvement is extremely rare, the stomach being the most frequently involved site among them. We report a case of gastric mucormycosis in a 37 year old male alcoholic with gastric ulcer. On histological examination, characteristic findings of hyphae with irregular width and right angle branchings were observed in the gastric mucosa and ulcer debris. The diagnosis of gastric mucormycosis was made by the characteristic histological nature. The patient was treated aggressively with antibiotics and antiulcer regimen for 6 weeks, and then no fungus was present on follow up biopsy of gastric mucosa.

Bypass of Superior Vena Cava with Spiral Vein Graft / 대한흉부외과학회지

A 49-year-old female patient who had obstruction of superior vena cava(SVC) with SVC syndrome was successfully managed by bypass operation of superior vena cava with spiral vein graft. A composite spiral vein graft was placed between the right innominate vein and the right atrium to bypass the occluded SVC. The graft was constructed from the patient's own saphenous vein, which was split longitudinally and wrapped around a stent in spiral fashion and the edges of the vein were sutured together to form a large autogenous conduit. The patient was relieved of SVC obstructive symtoms and signs and discharged 21 days postoperatively without any complication.

A Case of Primary Systemic Amyloidosis Predominantly Presenting Nephrotic Syndrome and Peripheral Neuropathy / 대한신장학회잡지

Primary systemic amyloidosis is a progressive disease that is frequently fatal. Nephrotic syndrome is present in almost one-third, congestive heart failure in one-quarter, and peripheral neuropathy in one-sixth of patients at the time of diagnosis. If heart or renal failure are presented, survival rate is poor. We experienced a case of a 66 year-old female patient who had complained lower leg edema and paresthesia of extremities for about 5 months. The laboratory findings were consistent with nephrotic syndrome, but the lower leg edema was non-pitting and the cause of paresthesia was unknown. We performed kidney and nerve biopsy and confirmed a case of primary systemic amyloidosis. In this case, presence of postural hypotension, probable cardiac involvement and relatively long spikes along the outside of the glomerular capillary loops on methenamine silver stain is suggestive of poor prognosis. We can predict chronic renal failure and congestive heart failure in the course of this case. We report a case of primary systemic amyloidosis predominantly presenting nephrotic syndrome and peripheral neuropathy with review of related literatures.