Clinical Utility of Chimerism Status Assessed by Lineage-Specific Short Tandem Repeat Analysis: Experience from Four Cases of Allogeneic Stem Cell Transplantation / 대한진단검사의학회지

Chimerism testing permits early prediction and documentation of successful engraftment, and also facilitates detection of impending graft rejection. In this study, we serially monitored chimerism status by short tandem repeat-based PCR in nucleated cells (NC), T cells and natural killer (NK) cells after myeloablative allogeneic stem cell transplantation (SCT). Four patients with myeloid malignancies showed discrepant chimerism results among those three fractions. Three patients had mixed chimerism (MC) of donor/host T cells at a time point around the onset of chronic graft-versus-host disease (GVHD). In two patients with disease relapse, MC of NK cells preceded a morphological relapse or NK cells showed a higher percentage of patient cells compared to NC. Therefore, our study shows that chimerism analysis in lineage-specific cells might be useful in predicting clinical outcome after allogeneic SCT in certain patients.

Limb-shaking Transient Ischemic Attack in Carotid Artery Stenosis

No abstract available.

Analysis of Ictal Electrocorticographic Features in Nonlesional Neocortical Epilepsy / 대한간질학회지

BACKGROUND: To characterize the ictal electrocorticographic features in relation to surgical outcome in nonlesional neocortical epilepsy (NE). METHODS: Seventeen patients with intractable NE underwent surgeries after chronic subdural recordings. All patients did not have any lesions on brain MRI, which was confirmed by pathology postoperatively. One hundred and eighty one ictal EEGs recorded from subdural electrodes were analyzed. Surgical outcome was determined by seizure reduction rate, and free or more than 75% reduction was defined as favorable outcome. The mean duration of follow-up was 55+/-8.7 months. RESULTS: Reproducible ictal onset zone (IOZ) in more than a half of seizures (p=0.002), and persistent ictal discharges in IOZ from the onset to the end of seizure were found more frequently in the patients with good outcome (p=0.004). Ictal onset patterns consisting of low voltage fast or high amplitude beta spikes predicted a good surgical outcome while rhythmic sinusoidal activity or rhythmic spike/sharp wave were predictive of poor outcome (p=0.01). The ictal onset rhythm consisted of gamma or beta frequencies was more prevalent in the favorable group (p=0.003). CONCLUSIONS: The presence of stable ictal circuit suggested by the consistent earliest activation in more than 50% of seizures and the active participation of IOZ throughout the attack were valuable prognostic factors in addition to the morphology and frequency of ictal onset rhythm.

Molecular Epidemiological Typing of Clinical Strains of Methicillin-Resistant Staphylococcus aureus / 대한임상미생물학회지

BACKGROUND: Meicillin-resistant Staphylococcus aureus(MRSA) is a common cause of nosocomial infections worldwide. Identification of strains by molecular typing facilitates epidemiological studies and improves disease control This study was performed to determine the usefulness of mecA-associated hypervariable region(HVR) polymerase chain reaction (PCR) and random amplified polymorphic DNA(RAPD) analysis in the investigation of a nosocomial MRSA infections. METHODS: Methicillin-resistance was identified by NCCLS disk diffusion method using the oxacillin disk. And PCR was done for detection of mecA gene. Antimicrobial susceptibility test, HVR-PCR and RAPD using 3 primers were performed for epidemiological analysis on isolates of MRSA. RESULTS: During the period from 1997 Dec. to 1998 May, 120 strains of S. aureus were isolated from clinical specimens. Among them, 78 strains were MRSA, and 72 strains were mecA positive. The strains of mecA positive MRSA were classified into four types by antibiogram, six genotypes by HVR-PCR, and 29 groups by RAPD using three primers. The combination of HVR genotypes and RAPD analysis showed 43 different types in 72 mecA positive MRSA isolates The five strains which were repeatedly isolated from the same patients showed the same HVR genotypes and RAPD analysis. CONCLUSIONS: Antibiogram, HVR-PCR, and RAPD could classify MRSA isolates into only 4-6 types, respectively, but combination of these methods could improve the typability. And combination of results of RAPD analysis using three primers were better than that using one primer in epidemiological studies of MRSA because of same reasons. It can be concluded that molecular typing of MRSA using HVR-PCR and RAPD assay is useful in epidemiolgical investigation of nosocomial infections caused by MRSA, because of its simplicity and reproducibility.