Current Challenges in Bacterial Transcriptomics

Over the past decade or so, dramatic developments in our ability to experimentally determine the content and function of genomes have taken place. In particular, next-generation sequencing technologies are now inspiring a new understanding of bacterial transcriptomes on a global scale. In bacterial cells, whole-transcriptome studies have not received attention, owing to the general view that bacterial genomes are simple. However, several recent RNA sequencing results are revealing unexpected levels of complexity in bacterial transcriptomes, indicating that the transcribed regions of genomes are much larger and complex than previously anticipated. In particular, these data show a wide array of small RNAs, antisense RNAs, and alternative transcripts. Here, we review how current transcriptomics are now revolutionizing our understanding of the complexity and regulation of bacterial transcriptomes.

Changes of Hemodynamics and Bispectral Index by Tracheal Intubation according to Effect-site Concentration of Remifentanil during Propofol Anesthesia / 대한마취과학회지

BACKGROUND: Combination of propofol and remifentanil is an ideal regimen for total intravenous anesthesia, and the bispectral index (BIS) has been used as an indicator of the sedative state during anesthesia. This study examined the effect of remifentanil on the mean arterial pressure (MAP), heart rate (HR) and BIS to laryngoscopy and tracheal intubation with 4microgram/ml of fixed target effect-site concentration infusion of propofol. METHODS: In this double-blind study, fifty-one ASA physical status I-II patients, aged 20-60 yr undergoing elective surgery were randomly assigned to one of four groups according to the target effect-site concentration of remifentanil (0, 2, 3, 4 ng/ml). The target-controlled infusion (TCI) of remifentanil was initiated after the effect-site concentration of propofol was maintained with 4microgram/ml. After target effect-site concentration of remifentanil was reached, a neuromuscular blockade was produced by rocuronium 1 mg/kg and tracheal intubation was performed after 90 seconds. MAP, HR and BIS were measured at pre-induction, after reaching target effect-site concentration of propofol and remifentanil, before and after tracheal intubation. RESULTS: The changes of MAP, HR and BIS after tracheal intubation were negatively correlated with remifentanil effect-site concentration. CONCLUSIONS: Remifentanil attenuated the hemodynamic responses due to tracheal intubation and decreased BIS after tracheal intubation in a comparable dose-dependent fashion.

Iatrogenic Vertebro-vertebral Arteriovenous Fistula Associated with Internal Jugular Vein Catheterization: A case report / 대한마취과학회지

Iatrogenic vertebro-vertebral arteriovenous fistula (AVF) is an uncommon complication resulting from various procedures such as central venous catheter insertion. The incidence may be underestimated since the diagnosis is not easy because of its rarity. A central venous catheterization via the internal jugular vein was attempted in a 43-year-old female who presented for intracranial aneurysmal clipping under general anesthesia. Inadvertent arterial puncture was recognized as pulsatile arterial blood flow through the needle. The needle was removed and local compression was applied to the puncture site. The catheter was inserted via the right femoral vein. After surgery, the patient recovered from anesthesia without any complications. On postoperative day 5, thrill and bruit on the right side of the neck were noted on physical examination. Angiography confirmed vertebro-vertebral AVF, which was successfully obliterated with a stent 3 months later.

A Case of Dengue Hemorrhagic Fever Imported from Africa / 감염

Dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) is an acute febrile illness characterized by hemorrhagic phenomenon and hypovolemic shock due to increased vascular permeability and plasma leakage in patients infected with any one of four serotypes of dengue virus. The disease is one of the principal causes of hospitalization and death among children in several south-east Asian, central and south American, and African countries. With increasing use of air or ship transport, more travelers and sailors to the tropics are returning within the incubation period of acute febrile infection. Herein we reported the first Korean case of dengue hemorrhagic fever imported from Africa. We experienced a Korean sailor who complains of fever, chill, nausea, and epistaxis after the return from Mombasa, Kenya. His fellows also showed the similar complains. His illness improved spontaneously and the indirect immunofluorescent antibody testing revealed antibody titer of 1:1024 or more.

Primary Malignant Melanoma of the Rectum

Malignant melanoma arising from the mucosal surface is a rare, virulent malignant neoplasm frequently associated with an extremely poor prognosis. The sites of initial presentation include the nose, oral cavity, larynx, vulva, vagina, anal canal and rectum. Primary melanoma of the rectum is extremely rare and its histogenesis is controversial. We present a case of primary malignant melanoma arising from the rectum in a 77-year-old woman who presented with intermittent anal bleeding for 2 months. Colonoscopic examination of the rectum revealed a 3.5 3.0 2.7 cm exophytic tumor with a granular surface in the rectum, 5cm from the anal verge. Black colored pigmentation was detected. Distant metastasis to liver was detected on abdominal CT scan. Light microscopy of tumor revealed malignant melanocytes surrounded by normal mucosa. The tumor cells reacted positively for immunohistochemical staining with S-100 protein and HMB-45. Clinical and laboratory examination excluded the presence of melanoma at sites other than rectum. Local excision of the tumor was performed.

Adult-onset Kawsaki Disease Complicated by Splenic Infarction and Coronary Aneurysm / 감염

Kawasaki disease or mucocutaneous lymph node syndrome is an acute inflammatory illness of childhood characterized by systemic panvasculitis. It presents with high fever, dramatic changes of the skin and mucous membranes, and lymphadenopathy. Adult-onset Kawasaki disease is rare and reports on coronary involvement in adult are even rarer. Herein, we report a case of adult-onset Kawasaki disease complicated by splenic infarction and development of coronary aneurysm even despite of treatment with intravenous gamma globulin. A 20-year-old man presented with fever, erytheatous rash, induration and desquamation of hands and feet, pulmonary edema and shock due to cardiomyopathy, splenic infarction, bilateral conjunctivitis, jaundice, and cervical lymphadenopathy. After Kawasaki disease was suspected, intravenous gamma globulin (2 g/kg once) and aspirin (6 g/day) were administered. On the 30th hospital day, transesophageal echocardiography showed one coronary aneurysm and coronary angiography showed three aneurysms. Eight months after the first admission, follow-up coronary angiography showed normalization of the previous coronary abnormalities.

Estimated Magnitude of an Outbreak of Vibrio parahaemolyticus Enteritis in Inchon, Korea / 감염

BACKGROUND: There are several reports on outbreaks of V. paraphaemolyticus enteritis, however, these are only complicated cases or microbiologic surveillance in marine environment. We experienced an outbreak associated with eating flavored crabs and investigated the magnitude of the outbreak on a large scale located in Inchon. METHOD: We took medical history and stool cultures from patients with diarrhea, visited the Inha University Hospital from September 14 to September 30, 1998. Pulsed-field gel electrophereis of isolates from stool culture performed to identify the relation. We counted the number of diarrheal patients visited the emergency rooms of 5 other general hospitals and 9 private clinics in Inchon from August 16 to September 30, 1998. We bought 6 crabs and 2 flavored crabs at a nearby market and cooked 6 crabs flavored at our hospital. Cultures from the flavored crabs stored at a refrigerator were done daily for consecutive 5 days. RESULTS: The outbreak began on September 5 and ended on September 29, 1998. The numbers of patients visiting ERs of 6 general hospitals and private clinics during outbreak were estimated 1,033 and 4,530, respectively. All 8 crabs revealed Vibrio spp., but identification up to species level was not possible. Pulsed-field gel electrophoresis of 12 isolates showed different patterns and suggested different sources. CONCLUSION: In 1998, an outbreak estimated more than 5,000 patients of V. parahaemolyticus enteritis occurred in Inchon, Korea. Because the magnitude of food-associated enteritis is enormous, that surpass the number which we assumed from clinical practice, early report and prompt investigation of such cases are necessary.

A Case of Transverse Myelitis as a First Manifestation of Systemic Lupus Erythematosus / 대한류마티스학회지

This is a case report of systemic lupus erythematosus presented as a transverse myelitis. Central nervous system involvement in systemic lupus erythematosus is a relatively common complication. But the transverse myelitis as a central nervous system involvement in systemic lupus erythematosus is rare and the transverse myelitis as the first manifestation of systemic lupus erythematosus has not been reported in Korea. Thus we report a case of the transverse myelitis as a first manifestation of systemic lupus erythematosus with the literature review.