Two Cases of Russell Body Gastritis Treated by Helicobacter pylori Eradication

Russell body gastritis was first defined in 1998, but not many cases have been reported since then. The exact causes and process of this condition are unknown yet; however, considering the reported cases, it has been highly suggested to have correlation with Helicobacter pylori infection. Russell body gastritis has a non-specific clinical presentation of gastritis such as gastric mucosal edema in the macroscopic view. It can be mistaken as xanthoma, signet ring cell carcinoma, or a malignant lymphoma including mucosa-associated lymphoid tissue lymphoma and plasmocytoma. Russell body gastritis features polyclonal immunoglobulin and is differentiated from Mott cancer, of which immune globulin has monoclonal aspect. Authors report here two cases of Russell body gastritis with examined endoscopic findings as well as a review of related literature on the association of all reported cases of Russell body gastritis with H. pylori infection.

Identification of Fastidious Mycobacteria other than M. tuberculosis ( MOTT ) by Comparative Sequence Analysis of rpoB and 16S rDNA

Conventional tests for the identification of mycobacteria may frequently result in erroneous identification and underestimate the diversity within the genus Mycobacterium. However, this problem can be overcome by molecular approach like as 16S rRNA gene (rDNA) or RNA polymerase gene (rpoB) sequence analysis. In this study, a molecular approach analyzing partial sequence of 16S rDNA and rpoB gene was applied to mycobacteria other than M tuberculosis (MOTT) isolates that had not been definitely identified by conventional physical and biochemical tests. Among the eighteen isolates included in this study, twelve isolates could be identified to the species level and six were identified to the complex level. Compared with the results by 16S rDNA analysis, the rpoB analysis could di6erentiate some of the strains into the subspecies level.

Survey on Changes in Mycobacterial Testing Practicies in Korean Laboratories / 대한임상미생물학회지

BACKGROUND: Since 1997 in which first survey for mycobacterial practices of hospitals in Korea were carried on, changes of practice and concept in mycobacterial testing have been expected because advanced testing methods have been surged for last five-year-period. We purposed to follow-up survey to monitor practices changes, and in addition, situation of quality control. METHODS: Questionnaires was composed of items including mycobacterial test methods, test volume, turnaround time (TAT), and quality control measure. It was sent to 90 laboratories of general hospitals, tuberculosis specialty hospitals and commercial laboratories in April 2001. RESULTS: Sixty-seven (74%) of 90 laboratories replied to this survey. Five of 67 laboratories (7%) were using fluorochrome method for AFB stains. In five among 58 laboratories that performed AFB cultures (8%), liquid media have been used. Mycobacterial species was identified by molecular biologic methods or high-performance liquid chromatography in 18 laboratories (34%). Average TAT of culture and identification for Mycobacterium tuberculosis was 11 days at the laboratory using Mycobacteria Growth Indicator Tube (MGIT) 9600 system and PCR method, while that at the laboratory using Ogawa media and biochemical method was 35.8 days. TATs of susceptibility tests undertaken at three laboratories were 28-60 days. Only six laboratories were joining external quality control program, even though most laboratories wanted to participate in. CONCLUSIONS: TATs for mycobacterial culture and susceptibility tests were too long to have the laboratories take a pivotal role to control tuberculosis. To improve Korean mycobacterial laboratories, it is necessary that the national health insurance system supports the newer rapid methods for mycobacterial tests and nationwide external quality control program is introduced.

Clinical Finding of MDR Tuberculosis and Frequency of MOTT / 결핵

BACKGROUND: The frequency of MOTT has risen as the prevalence of tuberculosis has been declining. Our country has been also. The most of MOTT was resistant to the major anti-tuberculous drugs. METHOD: To compare clinical characteristics and frequencies of MDR tuverculosis with MOTT, the author studied 65 patients showing AFB culture positive with sputum. The data were collected from 176 patients who had been admitted at the National Masan Tuberculosis Hospital from May to June, 1997 to April, 1998. RESULTS: The frequency of MDR tuberculosis was 43.1% and that of MOTT was 9.2%. Among 65 isolated my-cobacteria, 3 cases were M. intracellulare, 2 cases were M. fortuitum, and 1 case was unidentified MOTT. The most frequent age group in 65 culture positive patients was 4th decade and the mean age was 44. The mean age was 61 in MOTT and 42 in M. tuberculosis and bad significant difference(p<0.01). The numbers with past history of treatment were 2.3 in MDR tuberculosis and 1.7 in non-MDR tuberculosis and had significant difference(p<0.05). At the time of admisson, the most frequent regiment for the theatment of MDR tuberculosis was 24 months regimen(85.7%) with the 2nd line anti-tuberculosis drugs. For non-MDR tuberculosis, 9 or 12 months regimen (72.9%) with the 1st line anti-tuberculosis drugs and had significant difference(p<0.01). At the time of admission, the symptom of weight loss was shown in 84.7% of M. tuberculosis and 50.0% in MOTT and there was significant difference(p<0.05) between them. All of the MOTT were identified to be resistant against INH and PAS. Drug resistane rates to INH, OFX(p<0.01) and PAS(p<0.05) in MOTT were higher than in MDR. All of three M. intracellulare strains were resistant to INH, RFP, PAS and OFX. All of two M. fortuitum strains were resistant to most anti-tuberculosis drugs. And the other MOTT was resistant to INH, EMB and PAS. CONCLUSION: MOTT was more common in elderly patients than M. tuberculosis. MOTT cases should be considered to be the probability of multiple drug resistance and treatment failure during the 1st treatment because they showed more resistance to anti-tuberculosis drugs than M. tuberculosis cases. Therefore, there should be more careful investigations for clinical characteristics, natural history of disease, and efficient management for MOTT.