Reconstruction of the Korean Asbestos Job Exposure Matrix

Background@#A job-exposure matrix (JEM) is an important surrogate indicator to evaluate past exposure levels. Although a Korean asbestos JEM has been constructed previously, this JEM includes only a few industrial and occupational groups. This study aimed to reconstruct the JEM by integrating the latest organized data to improve its utility. @*Methods@#We used recent Korean standard industry and occupation codes and extracted 36 articles from a systematic literature review to initiate the reconstruction of the previous Korean asbestos JEM. The resulting data consisted of 141 combinations of industrial and occupational groups. Data from the Netherlands's JEM were also reviewed and categorized into 70 industrial and 117 occupational groups by matching with the Korean data. We also utilized Germany's data, which consisted of 10 industrial and 14 occupational groups. @*Results@#The reconstructed Korean asbestos JEM had 141 combinations of industries and occupations. The time periods are from the 1980s to the 2000s in 10-year intervals. Most of the data were distributed between the 1990s and the 2000s. Occupations with high exposure to asbestos included knitting and weaving machine operators, automobile mechanics or assemblers, ship mechanics or assemblers, mineral ore and stone products processing mechanics, and metal casting machine operators or mold makers. @*Conclusions@#The reconstructed Korean asbestos JEM has expanded the type and duration of the occupational groups of the previous JEM and can serve as an important reference tool for evaluating asbestos exposure and designing compensation and prevention policies in Korea.

Reconstruction of the Korean Asbestos Job Exposure Matrix

Background@#A job-exposure matrix (JEM) is an important surrogate indicator to evaluate past exposure levels. Although a Korean asbestos JEM has been constructed previously, this JEM includes only a few industrial and occupational groups. This study aimed to reconstruct the JEM by integrating the latest organized data to improve its utility. @*Methods@#We used recent Korean standard industry and occupation codes and extracted 36 articles from a systematic literature review to initiate the reconstruction of the previous Korean asbestos JEM. The resulting data consisted of 141 combinations of industrial and occupational groups. Data from the Netherlands's JEM were also reviewed and categorized into 70 industrial and 117 occupational groups by matching with the Korean data. We also utilized Germany's data, which consisted of 10 industrial and 14 occupational groups. @*Results@#The reconstructed Korean asbestos JEM had 141 combinations of industries and occupations. The time periods are from the 1980s to the 2000s in 10-year intervals. Most of the data were distributed between the 1990s and the 2000s. Occupations with high exposure to asbestos included knitting and weaving machine operators, automobile mechanics or assemblers, ship mechanics or assemblers, mineral ore and stone products processing mechanics, and metal casting machine operators or mold makers. @*Conclusions@#The reconstructed Korean asbestos JEM has expanded the type and duration of the occupational groups of the previous JEM and can serve as an important reference tool for evaluating asbestos exposure and designing compensation and prevention policies in Korea.

The study of glucose-6-phosphate dehydrogenase deficiency from persons affected by Hansen's disease in Korea / 나학회지

Background@#Glucose-6-phosphate dehydrogenase deficiency is the most common enzyme deficiency disease. Drugs that cause deficiency-related hemolytic responses include dapsone, which is taken as a therapeutic drug for Hansen's disease. Due to the hemolytic adverse effects, the deficiency test should be performed before the dapsone administration, but it is not conducted on the basis of low incidence in Korea. Thus, the monitoring of deficiency in patients with Hansen's disease was needed and the study was undertaken. @*Objective@#The aims of this study were to determine the prevalence of deficiency and gene mutations from persons affected by Hansen's disease in Korea. @*Methods@#Hemanalysis and activity test by venipuncture were performed against the 339 persons affected by Hansen's disease. All subjects were tested for detection of mutations by the polymerase chain reaction. @*Results@#The prevalence of anemia was 45.5% and the prevalence of deficiency was 1.2% from persons affected by Hansen's disease. 2 gene mutations, Mahidol and Mediterranean, were detected in foreign participants (Myanmar and Nepal). @*Conclusion@#In this study, we detected that the prevalence of deficiency and gene mutation was low, thus inferred that anemia was relatively less relevant to deficiency in persons affected by Hansen's disease. However, the number of participant in our study is small, and many studies reported that deficiency test should be performed before the dapsone administration, therefore, we suggest that continuous monitoring of patients with Hansen's disease is necessary.

The Study of Association between Leprosy's Type and Apolipoprotein E Gene in Korean Persons Affected by Leprosy / 나학회지

Background@#Apolipoprotein E protein is a family of apolipoproteins that play an important role in lipid metabolism. Apolipoprotein E genotype and single-nucleotide polymorphisms of genes are known to induce neurodegenerative diseases and cardiovascular diseases. Recently, it has been reported that apolipoprotein E is related to Hansen's disease by regulating genes related to lipid metabolism. @*Objective@#In this study, we investigated that relationship of apolipoprotein E genotype with leprosy type and single-nucleotide polymorphism in korean persons affected by leprosy. @*Methods@#The Apolipoprotein E genotype was confirmed using the polymerase chain reaction from korean persons affected by leprosy. Real-time polymerase chain reaction using probes confirmed the rs405509 and rs439401 of Apolipoprotein E. The identified genotype was cross-analyzed with each single-nucleotide polymorphism results and leprosy type by chi-squared test. @*Results@#The distribution of apolipoprotein E genotypes was E3/E3 76.7%, E3/E4 17.4%, E2/E2 2.3%, E2/E3 2.3%, E2/E4 1.2% were in order. The frequencies of the apolipoprotein E allele were identified in the order of ε2 4.1%, ε3 86.6%, and ε4 9.3%. By type of leprosy, ε2 allele increased 2.2 times in multibacillary than pauacibacillary(4.8% vs 2.2%), and ε4 allele decreased 2.8 times in multibacillary than pauacibacillary(6.3% vs 17.4%). ApoE genotype was cross-analyzed with rs405509·rs439401, and there was a statistically significant association. @*Conclusion@#Apolipoprotein E genotype is associated with leprosy types in korean persons affected by leprosy. The research for apolipoprotein E gene is thought to be helpful in basic research on the pathogenesis of leprosy.who underwent surgery.

Approach Using Multiple Biomarkers for Diagnosis of Hansen's Disease / 나학회지

Background@#The prevalence of leprosy has almost reached the goal of World Health Organization. Accordingly, attention to leprosy and the number of skilled doctors who can diagnosis the leprosy upon clinical manifestations were decreased which caused the delayed diagnosis of leprosy. @*Objective@#Serum C-reactive protein, interferon gamma-induced protein 10, anti-phenolic-glycolipid-1 IgM are biomarkers associated with multi-bacillary leprosy. Therefore, we investigated whether the use of multiple biomarkers has diagnostic value. @*Methods@#The samples were collected from August 2012 to December 2019 at our institute. Through various statistic methods, multiple biomarkers and equation were compared in multi-bacillary patients, pauci-bacillary patients, contacts and different skin disease. @*Results@#Samples were collected from 21patients (17 multi-bacillary, 4 pauci-bacillary) and 17 from non-patients (7 from contacts, 10 from other skin disease). Serum level of C-reactive protein, interferon gamma-induced protein 10, anti-phenolic-glycolipid-1 IgM and equation showed statistical significance compared from patients to non-patients. Comparing multi-bacillary patients to pauci-bacillary patients, only anti-phenolic-glycolipid-1 IgM showed statistical significance. Each area under receiver operating characteristic curve of those biomarkers and equation was ≥0.70 and p≤0.05. The results of Equation using 3 indicators showed higher area under receiver operating characteristic curve and lower P value compared when each indicator was used. Also sensitivity and specificity of them presented meaningful data. @*Conclusion@#We confirmed that using integrated analysis of three biomarkers is more significant than the single indicator in the diagnosis of leprosy. In addition, the use of multiple biomarkers is thought to contribute to the management of leprosy in the community.

The study of glucose-6-phosphate dehydrogenase deficiency from persons affected by Hansen's disease in Korea / 나학회지

Background@#Glucose-6-phosphate dehydrogenase deficiency is the most common enzyme deficiency disease. Drugs that cause deficiency-related hemolytic responses include dapsone, which is taken as a therapeutic drug for Hansen's disease. Due to the hemolytic adverse effects, the deficiency test should be performed before the dapsone administration, but it is not conducted on the basis of low incidence in Korea. Thus, the monitoring of deficiency in patients with Hansen's disease was needed and the study was undertaken. @*Objective@#The aims of this study were to determine the prevalence of deficiency and gene mutations from persons affected by Hansen's disease in Korea. @*Methods@#Hemanalysis and activity test by venipuncture were performed against the 339 persons affected by Hansen's disease. All subjects were tested for detection of mutations by the polymerase chain reaction. @*Results@#The prevalence of anemia was 45.5% and the prevalence of deficiency was 1.2% from persons affected by Hansen's disease. 2 gene mutations, Mahidol and Mediterranean, were detected in foreign participants (Myanmar and Nepal). @*Conclusion@#In this study, we detected that the prevalence of deficiency and gene mutation was low, thus inferred that anemia was relatively less relevant to deficiency in persons affected by Hansen's disease. However, the number of participant in our study is small, and many studies reported that deficiency test should be performed before the dapsone administration, therefore, we suggest that continuous monitoring of patients with Hansen's disease is necessary.

The Study of Association between Leprosy's Type and Apolipoprotein E Gene in Korean Persons Affected by Leprosy / 나학회지

Background@#Apolipoprotein E protein is a family of apolipoproteins that play an important role in lipid metabolism. Apolipoprotein E genotype and single-nucleotide polymorphisms of genes are known to induce neurodegenerative diseases and cardiovascular diseases. Recently, it has been reported that apolipoprotein E is related to Hansen's disease by regulating genes related to lipid metabolism. @*Objective@#In this study, we investigated that relationship of apolipoprotein E genotype with leprosy type and single-nucleotide polymorphism in korean persons affected by leprosy. @*Methods@#The Apolipoprotein E genotype was confirmed using the polymerase chain reaction from korean persons affected by leprosy. Real-time polymerase chain reaction using probes confirmed the rs405509 and rs439401 of Apolipoprotein E. The identified genotype was cross-analyzed with each single-nucleotide polymorphism results and leprosy type by chi-squared test. @*Results@#The distribution of apolipoprotein E genotypes was E3/E3 76.7%, E3/E4 17.4%, E2/E2 2.3%, E2/E3 2.3%, E2/E4 1.2% were in order. The frequencies of the apolipoprotein E allele were identified in the order of ε2 4.1%, ε3 86.6%, and ε4 9.3%. By type of leprosy, ε2 allele increased 2.2 times in multibacillary than pauacibacillary(4.8% vs 2.2%), and ε4 allele decreased 2.8 times in multibacillary than pauacibacillary(6.3% vs 17.4%). ApoE genotype was cross-analyzed with rs405509·rs439401, and there was a statistically significant association. @*Conclusion@#Apolipoprotein E genotype is associated with leprosy types in korean persons affected by leprosy. The research for apolipoprotein E gene is thought to be helpful in basic research on the pathogenesis of leprosy.who underwent surgery.

Approach Using Multiple Biomarkers for Diagnosis of Hansen's Disease / 나학회지

Background@#The prevalence of leprosy has almost reached the goal of World Health Organization. Accordingly, attention to leprosy and the number of skilled doctors who can diagnosis the leprosy upon clinical manifestations were decreased which caused the delayed diagnosis of leprosy. @*Objective@#Serum C-reactive protein, interferon gamma-induced protein 10, anti-phenolic-glycolipid-1 IgM are biomarkers associated with multi-bacillary leprosy. Therefore, we investigated whether the use of multiple biomarkers has diagnostic value. @*Methods@#The samples were collected from August 2012 to December 2019 at our institute. Through various statistic methods, multiple biomarkers and equation were compared in multi-bacillary patients, pauci-bacillary patients, contacts and different skin disease. @*Results@#Samples were collected from 21patients (17 multi-bacillary, 4 pauci-bacillary) and 17 from non-patients (7 from contacts, 10 from other skin disease). Serum level of C-reactive protein, interferon gamma-induced protein 10, anti-phenolic-glycolipid-1 IgM and equation showed statistical significance compared from patients to non-patients. Comparing multi-bacillary patients to pauci-bacillary patients, only anti-phenolic-glycolipid-1 IgM showed statistical significance. Each area under receiver operating characteristic curve of those biomarkers and equation was ≥0.70 and p≤0.05. The results of Equation using 3 indicators showed higher area under receiver operating characteristic curve and lower P value compared when each indicator was used. Also sensitivity and specificity of them presented meaningful data. @*Conclusion@#We confirmed that using integrated analysis of three biomarkers is more significant than the single indicator in the diagnosis of leprosy. In addition, the use of multiple biomarkers is thought to contribute to the management of leprosy in the community.

Comparison of Effective DNA Extraction method for Molecular biological study of Mycobacterium leprae / 나학회지

BACKGROUND@#Leprosy is an important health problem in many geographical areas yet. It is caused through a cough or contact with fluid from the nose of a person infected by Mycobacterium leprae. Study of DNA from M. leprae is important to understand essentiality for leprosy. However, there is no standard in many parts, so various studies are needed.OBJECTS: In this study, DNA extraction method were confirmed for the effective detection of M. leprae. And restriction enzyme fragment length polymorphism typing and high resolution melt (HRM) analysis were performed for comparison with sequencing analysis.@*METHODS@#Compared with three DNA extraction methods (BB, SM and SP) with real-time polymerase chain reaction (PCR). Analysis single nucleotide polymorphism (SNP) genotype and tandem repeats by PCR amplification, and then compare with sequence.@*RESULTS@#BB method was effective when measuring the concentration and threshold cycle (Ct) compared with SM and SP methods. When compared with restriction fragment length polymorphism typing method and sequence analysis, all methods were suitable for SNP1 and 3 type classification. Tandem repeats values of BB method were correspond to sequence analysis than SM and SP methods in HRM analysis.@*CONCLUSIONS@#The DNA extraction method by bead is useful approach for studying of M. leprae.

Effect of temperature and medium on the viability of Mycobacterium leprae during long term-storage / 나학회지

BACKGROUND@#Mycobacterium leprae (M. leprae) is pathogenic bacterium with polymorphic, acid-fast properties and causes leprosy that it is called Hansen's disease. Leprosy can be completely cured using multidrug therapy (MDT), but it is not easy to eradicate leprosy and M. leprae on the planet.OBJECT: We still do not understand the exact pathogenesis mechanism of leprosy. The main reason is that we cannot grow bacteria in vitro. Therefore, quantitative measurement and damage-free storage of live M. leprae are very important.@*METHODS@#Here, we generated bacteria stocks of M. leprae using HBSS with 0.05% tween 80 or freezing solution 11 months ago and evaluated conditional survival of bacteria by Propidium monoazide (PMA) staining, real-time PCR.@*RESULTS@#There were assessed for bacteria viability under the conditions of each temperature or medium by delta-Ct level of real-time PCR. We also observed that frozen-stored M. leprae (2.14) compare to refrigerated-stored M. leprae (1.03) was significant decreased delta-Ct in HBSS (P<0.05). However, frozen-stored M. leprae (1.14) was not difference refrigerated-stored M. leprae (0.84) in freezing solution (P=NS). Real-time PCR with SYBR green method was reliable for results and statistical significance, but data for real-time PCR with probe method were unreliable.@*CONCLUSIONS@#Taken together, these results indicated that freezing solution regardless of temperature increase much more bacterial survival. In addition, if use not freezing solution, M. leprae must be stored frozen.

Pretreatment neutrophil-to-lymphocyte ratio and its dynamic change during neoadjuvant chemotherapy as poor prognostic factors in advanced ovarian cancer

OBJECTIVE: The purpose of this study was to determine the prognostic implications of the pretreatment neutrophil-to-lymphocyte ratio (NLR) and its dynamic change during chemotherapy in patients with advanced epithelial ovarian cancer undergoing neoadjuvant chemotherapy. METHODS: We performed a retrospective analysis of 203 patients who underwent neoadjuvant chemotherapy prior to interval debulking surgery for advanced-stage ovarian cancer at Yonsei Cancer Hospital between 2007 and 2015. Pretreatment NLR was evaluated before starting neoadjuvant chemotherapy. Change in NLR was defined as the post-neoadjuvant NLR value divided by the initial value. The correlation of NLR and its dynamic change with chemotherapy response score, response rate, and recurrence was analyzed. RESULTS: The NLR ranged from 0.64 to 22.8. In univariate analyses, a higher pretreatment NLR (> 3.81) was associated with poor overall survival (OS), but not progression-free survival (PFS). Through multivariate analysis, high pretreatment NLR was shown to be an independent parameter affecting OS, but not necessarily PFS. Changes in NLR during chemotherapy were better predictors of PFS than baseline NLR. Patients with increased NLR during chemotherapy showed significantly poor PFS, and this change was an independent predictor of PFS. CONCLUSION: Pretreatment NLR and its dynamic change during chemotherapy may be important prognostic factors in patients who undergo neoadjuvant chemotherapy.

Comprehensive Transcriptome Profiling of Balding and Non-Balding Scalps in Trichorhinophalangeal Syndrome Type I Patient

BACKGROUND: Trichorhinophalangeal syndrome (TRPS) patients tend to have alopecia that appears to be androgenetic, and this genetic model might give clues to the pathogenesis of hair loss or hair morphogenesis. OBJECTIVE: This study was conducted to identify additional genetic evidence of TRPS and hair morphogenesis from a TRPS patient. METHODS: From one TRPS type I patient, we extracted RNA and profiled whole transcriptome in non-balding and balding scalp areas using high-throughput RNA sequencing. RESULTS: We found a total of 26,320 genes, which comprised 14,892 known genes with new isoforms and 4,883 novel genes from the non-balding and balding areas. Among these, a total of 1,242 genes showed different expression in the two scalp areas (p0). Several genes related to the skin and hair, alopecia, and the TRPS1 gene were validated by qRT-PCR. Twelve of 15 genes (KRT6C, KRTAP3-1, MKI67, GPRC5D, TYRP1, DSC1, PMEL, WIF1, SOX21, TINAG, PTGDS, and TRPS1) were down-regulated (10 genes: p0.05), and the three other genes (HBA2, GAL, and DES) were up-regulated (p<0.01) in the balding scalp. Many genes related to keratin and hair development were down-regulated in the balding scalp of the TRPS type I patient. In particular, the TRPS1 gene might be related to androgen metabolism and hair morphogenesis. CONCLUSION: Our result could suggest a novel perspective and evidence to support further study of TRPS and hair morphogenesis.

Relationship between serum 25-hydroxyvitamin D and interleukin-31 levels, and the severity of atopic dermatitis in children / 소아과

PURPOSE: Atopic dermatitis (AD) is a chronic inflammatory relapsing skin disorder. Vitamin D plays a pivotal role in the development of AD, and interleukin (IL) 31 is known to be related to pruritus in AD. The aim of our study was to determine whether 25-hydroxyvitamin D (25(OH)D) levels are related to IL-31 levels or to the severity of AD. METHODS: We enrolled 91 children with AD and 32 control subjects without history or symptoms of allergic diseases. Blood was drawn to evaluate complete blood cell count, total eosinophil count (TEC), and total IgE, specific IgE to common allergens, 25(OH)D, and IL-31 levels. Serum 25(OH)D and IL-31 levels were measured using high-performance liquid chromatography and enzyme-linked immunosorbent assay, respectively. The scoring atopic dermatitis (SCORAD) index was used to evaluate the severity of AD. RESULTS: The mean 25(OH)D level was significantly lower in the AD group than in the control group; 25(OH)D decreased greatly in the moderate and severe AD groups compared with the mild AD group. Children with atopic sensitization showed significantly lower 25(OH)D levels than nonatopic children. However, serum IL-31 levels were not related to AD group, SCORAD index, or 25(OH)D levels. The SCORAD index was inversely correlated with serum 25(OH)D level and positively correlated with TECs and total IgE levels. Children with moderate and severe AD had significantly higher TECs than children with mild AD. CONCLUSION: Vitamin D is related to the severity of AD independently of IL-31.

A Pediatric Case of Toxic Hepatitis Induced by Hovenia Dulcis / 대한소아소화기영양학회지

Toxic hepatitis is a rare but devastating disease in children. Herbs are widely used in oriental medicine to treat various symptoms in Korea, however, several herbs have been reported to induce liver injury. We report a case of toxic hepatitis induced by Hovenia dulcis in a 3-year-old boy. He complained of nausea, abdominal discomfort, and jaundice. The patient had consumed water boiled with hovenia dulcis for about 1 year prior to presentation. A diagnosis of toxic hepatitis was made based on his history, laboratory data, viral markers, ultrasonography, and biopsied liver tissue. We administered supportive management for acute fulminant hepatitis but his symptoms and liver function progressed. He was transferred to another hospital for further evaluation and consideration for liver transplantation. Because acute liver failure due to herbs or dietary supplement taken for a long time is often fetal, it is important to make early diagnosis and stop taking the drug as soon as drug induced liver injury is suspected.

Increased Prevalence of H1N1-Induced Severe Lower Respiratory Tract Diseases in Children With Atopic Sensitization

PURPOSE: Viral infection is the most common aggravating factor for childhood asthma. Asthma may be a risk factor for severe respiratory symptoms in children with lower respiratory tract infections of viral etiology. Influenza A infection enhances Th2-polarization to house dust mites during the acute phase and leads to lung dysfunction in a mouse model. However, there are no data on the relationship between atopic sensitization and H1N1 (Influenza A) infection in humans. To investigate whether atopic sensitization is associated with the severity of H1N1 pneumonia, we compared clinical features and the atopic sensitization rate between children with and without H1N1 infection. METHODS: Using reverse transcription-polymerase chain reactions, we investigated H1N1 virus infection in 214 children who were hospitalized with high fever and respiratory symptoms from September 2009 to February 2010. We also performed immunoassays for total and specific IgEs to six common aeroallergens. Atopy was defined as positivity for more than one specific IgE. The clinical severity of pneumonia was evaluated based on intensive care unit admission, oxygen therapy, steroid therapy, and atelectasis. RESULTS: There were 70 H1N1-positive children, 42.9% of whom had pneumonia. Children with H1N1 infection were older and had a higher prevalence of atopic sensitization and pneumonia compared with H1N1-negative children. The rate of atelectasis was higher in children with H1N1 pneumonia than in children with non-H1N1 pneumonia. Among children with H1N1 viral infection, those with atopic sensitization had a higher prevalence of intensive care unit admission and oxygen therapy, and a longer duration of hospitalization than non-atopic children. There were no differences between atopic and non-atopic children without H1N1 viral infection. CONCLUSIONS: The prevalence of H1N1-induced severe lower respiratory tract diseases is higher in children with atopic sensitization.

Alternative Splicing and Its Impact as a Cancer Diagnostic Marker

Most genes are processed by alternative splicing for gene expression, resulting in the complexity of the transcriptome in eukaryotes. It allows a limited number of genes to encode various proteins with intricate functions. Alternative splicing is regulated by genetic mutations in cis-regulatory factors and epigenetic events. Furthermore, splicing events occur differently according to cell type, developmental stage, and various diseases, including cancer. Genome instability and flexible proteomes by alternative splicing could affect cancer cells to grow and survive, leading to metastasis. Cancer cells that are transformed by aberrant and uncontrolled mechanisms could produce alternative splicing to maintain and spread them continuously. Splicing variants in various cancers represent crucial roles for tumorigenesis. Taken together, the identification of alternative spliced variants as biomarkers to distinguish between normal and cancer cells could cast light on tumorigenesis.

Alternative Splicing and Its Impact as a Cancer Diagnostic Marker

Most genes are processed by alternative splicing for gene expression, resulting in the complexity of the transcriptome in eukaryotes. It allows a limited number of genes to encode various proteins with intricate functions. Alternative splicing is regulated by genetic mutations in cis-regulatory factors and epigenetic events. Furthermore, splicing events occur differently according to cell type, developmental stage, and various diseases, including cancer. Genome instability and flexible proteomes by alternative splicing could affect cancer cells to grow and survive, leading to metastasis. Cancer cells that are transformed by aberrant and uncontrolled mechanisms could produce alternative splicing to maintain and spread them continuously. Splicing variants in various cancers represent crucial roles for tumorigenesis. Taken together, the identification of alternative spliced variants as biomarkers to distinguish between normal and cancer cells could cast light on tumorigenesis.

Transposable Elements: No More 'Junk DNA'

Since the advent of whole-genome sequencing, transposable elements (TEs), just thought to be 'junk' DNA, have been noticed because of their numerous copies in various eukaryotic genomes. Many studies about TEs have been conducted to discover their functions in their host genomes. Based on the results of those studies, it has been generally accepted that they have a function to cause genomic and genetic variations. However, their infinite functions are not fully elucidated. Through various mechanisms, including de novo TE insertions, TE insertion-mediated deletions, and recombination events, they manipulate their host genomes. In this review, we focus on Alu, L1, human endogenous retrovirus, and short interspersed element/variable number of tandem repeats/Alu (SVA) elements and discuss how they have affected primate genomes, especially the human and chimpanzee genomes, since their divergence.

Tuberculous Peritonitis in a Patient with Rheumatoid Arthritis Treated with Infliximab

One of the severe adverse reactions to anti-tumor necrosis factor (TNF)-alpha therapy is the reactivation of tuberculosis. We present a case of tuberculous peritonitis in a 57-year-old woman with rheumatoid arthritis (RA) that appeared during treatment with infliximab. Confirming a diagnosis of tuberculous peritonitis is difficult and can be delayed because of the nonspecific symptoms, the rarity of the disease and the low detection rate of mycobacteria in ascites fluid. This case illustrates that prompt anti-tuberculous therapy is needed for suspected cases of tuberculous peritonitis in RA patients treated with infliximab.

Gastrointestinal Stromal Tumor

Gastrointestinal stromal tumor (GIST) is a relatively rare disease accounted for less than 1% of gastrointestinal tumors. In the past, surgery is the only reliable therapy for the locoregional GISTs. But with the development of the specific target agents such as imatinib or sunitinib, advanced metastatic GIST can be cured now. GISTs are incidentally found by endoscopic ultrasound or laparoscopic surgery for the abdominal mass and positive immunostain for KIT with characteristic histopathology is mandatory for the diagnosis. Mutational analyses for KIT and PDGFRA is helpful in the diagnosis and treatment of GISTs. Because most GISTs are potentially malignant and surgery itself has high recurrence rate, it should be treated at an early stage and chemotherapy should be considered aggressively. The tumor size, mitotic index, and the involved organs are important prognostic factors. In this paper, the pathogenesis of histopathology, clinical diagnosis and treatment of GISTs were reviewed.