Sung Ha Kang’s research while affiliated with Jeju National University and other places

Background Polymorphisms of methylenetetrahydrofolate reductase (MTHFR) gene are strongly associated with hypertension incidence, although such association is inconsistent among ethnicities studied. However, effects of polymorphisms of other genes related to folate metabolism besides MTHFR on hypertension susceptibility are not well known yet.Objective The aim of this study was to elucidate whether methionine synthase (MTR) 2756A>G and methionine synthase reductase (MTRR) 66A>G polymorphisms might be associated with risks of hypertension susceptibility in the Korean population.Methods Genotyping of these two polymorphisms was performed for 232 hypertensive patients and 247 unrelated healthy controls using polymerase chain reaction-restriction fragment length polymorphism technique.ResultsIn the present study, mutations of MTR 2756A>G and MTRR 66A>G polymorphisms were associated with increased and decreased susceptibility to hypertension, respectively. Allele combinations from these two polymorphisms were also related to hypertension prevalence. When polymorphism data were stratified according to clinical components of hypertension, The G allele of MTR 2756A>G polymorphism was significantly associated with an increased risk of hypertension in subjects with BMI < 26.1 kg/m2 (P = 0.004), WC < 87.2 in. (P = 0.021), FBG < 95.5 mg/dL (P = 0.011), triglyceride < 133.5 mg/dL (P = 0.034), and HDL-cholesterol < 52.2 mg/dL (P = 0.036). The G allele of MTRR 66A>G polymorphism was significantly associated with a decreased risk of hypertension in subjects with WC ≥ 87.2 in. (P = 0.029), FBG ≥ 95.5 mg/dL (P = 0.032) and triglyceride ≥ 133.5 mg/dL (P = 0.027).ConclusionMTR 2756A>G and MTRR 66A>G polymorphisms related to folate metabolism might be genetic markers for risk of hypertension in the Korean population.

The apolipoprotein (Apo) C3 and A4 genes, which are members of the ApoA1/C3/A4/A5 gene cluster, play important roles in lipid metabolism. Despite their importance, studies on the association between these polymorphisms in patients with hypertension are rare. In this study, we examined the associations of ApoC3 (−482C>T rs2854117, −455T>C rs2854116 and 3238G>C rs5128) and ApoA4 1687A>G rs5104 polymorphisms in Korean hypertensive patients. Three hundred and forty patients with hypertension and 515 healthy normotensive subjects were studied. ApoC3 and ApoA4 polymorphisms in the subjects were analyzed by polymerase chain reaction and restriction fragment length polymorphism. The four polymorphisms were not associated with susceptibility to hypertension. However, several haplotypes constructed from four polymorphisms of the ApoC3 and ApoA4 genes were associated with susceptibility to hypertension. With respect to the clinical parameters of hypertension, the −482C>T and −455T>C polymorphisms of the ApoC3 gene were associated with abnormal body mass index (P = 0.024) and triglyceride levels (P = 0.033) in the hypertensive group, respectively. Based on these results, the ApoC3 and ApoA4 polymorphisms might affect synergically susceptibility to hypertension in Koreans.

The Eutypella is a genus of fungi in the family Diatrypaceae, and well-known plant pathogens, is capable of infecting manyspecies of maple trees. We introduce here a case of Eutypella species isolated from a bronchoalveolar lavage in animmunocompromised patient with small cell lung cancer initially not suspected by SDA and LPCB stain and revealed by PCRand 18S rDNA sequencing. But, in this case, we couldn't judge whether this fungus was the pathogen for inflammation of lungand additional treatment was not needed for fungus isolation with no clinical problems. The human mycobiome includes 390fungal species detected on the skin, in the vagina, in the oral cavity, and in the digestive tract that includes 335 species and158 genera. Among these, 221 species are found only in the digestive tract, 88 only in the oral cavity, and 26 in both. Thesespecies belong to 126 genera of yeast and filamentous fungi, of the Ascomycota, Basidiomycota, and Zygomycota phyla. So, nomatter how sensitive the diagnosis is, the results of molecular diagnosis method for fungal infection must be carefullyconsidered with clinical conditions..

Roseomonas gilardii, a Gram-negative, non-motile, non-spore-forming, strictly aerobic, and pink-pigmented coccobacillus, isan uncommon species causing human infection. But, occasionally, it has been reported as a causative organism of opportunisticinfection in some countries. We report a case of bacteremia in a 51-year-old woman with endometrial cancer. She visited ouroutpatient clinic, complaining of cough, headache, and febrile sensation for 3 days after palliative chemotherapy performed 8days earlier. Cultures of the blood and the peripherally inserted central catheter were performed and bacteria were isolatedfrom cultures after 5 day incubation. Microbiological tests such as Gram staining, culture, and identification testing revealedRoseomonas gilardii. The patient was treated with antibiotics for 9 days and discharged. This case of Roseomonas gilardiibacteremia from the peripherally inserted central catheter in a patient with endometrial cancer suggests the importance ofdiagnostic tools for accurate identification of unusual causative organisms of bacteremia in immunocompromised patients.

Background and objectives: Residual platelet reactivity in patients who are taking clopidogrel is commonly measured with VerifyNow assay, which is based on the principle of light transmission aggregometry. However, to evaluate the residual platelet reactivity, it would be more accurate if the reactivity of platelet glycoprotein (GP) IIb/IIIa is directly monitored. In this study, PAC1, a monoclonal antibody against activated platelet GP IIb/IIIa, was used to measure the residual platelet reactivity. Subjects and methods: Twenty seven patients with coronary artery disease taking clopidogrel were enrolled. Platelets in whole blood were stained with fluorescein isothiocyanate (FITC)-conjugated PAC1. Mean fluorescence intensity (MFI) and % positive platelets (PP) were measured with flow cytometry, and the binding index (BI; MFI × %PP/100) was calculated. P2Y12 reaction unit (PRU) and % inhibition of VerifyNow assay were also measured in the usual manner. Results: PRU of VerifyNow assay correlated significantly with MFI, %PP, and BI at 10 µM (r=0.59, 0.73, and 0.60, respectively, all p<0.005) and 20 µM of adenosine diphosphate (ADP; r=0.61, 0.75, and 0.63, respectively, all p<0.005). The % inhibition also correlated significantly with MFI, %PP, and BI at 10 µM (r=-0.60, -0.69, and -0.59, respectively, all p<0.005) and 20 µM of ADP (r=-0.63, -0.71, and -0.62, respectively, all p<0.005). Conclusion: Direct measurements of the reactivity of platelet GP IIb/IIIa were feasible using PAC1 and flow cytometry in patients taking clopidogrel. Further clinical studies are required to determine the cut-off values which would define high residual platelet reactivity in patients on this treatment protocol.

Background : Apolipoprotein E (ApoE) is an important substance responsible for the lipoprotein metabolism and thetransportation of lipid and known to play an important role in the body's physiological and pathological processes. Recently,ApoE genotyping test has been applied to the field of diagnostic methods for predicting high risk of Alzheimer's disease,cardiovascular diseases, as well as new diseases such as immune regulation disorders. Therefore, a faster and more accurateApoE genotyping test is required for the prevention of related disease and the general public health.Methods : We evaluated 220 serum specimens using two kinds of assays: one-stop Real-Q ApoE genotyping (BioSewoom,Seoul, Korea) and Seeplex ApoE ACE genotyping (Seegene, Seoul, Korea). The results were finally confirmed using sequencingas the reference. Statistical analysis was performed for the concordance rates between each assay and sequencing and thesensitivity and specificity were calculated with their 95% confidence intervals.Results : Sequencing results of 220 DNA samples showed 1 case of E2/E2, 139 of E3/E3, 9 of E4/E4, 17 of E2/E3, 4 ofE2/E4, 50 of E3/E4. The concordance rate between One-step Real-Q ApoE genotyping and sequencing was 100% (220/220),and that between Seeplex ApoE ACE genotyping and sequencing was 99.5% (219/220). Both sensitivity and specificity of OnestepReal-Q ApoE genotyping for every genotypes was 100%. The sensitivities and specificities of Seeplex ApoE ACEgenotyping were almost 100%, with two exception: 99.3% sensitivity in E3/E3 and 99.5% specificity in E2/E2.Conclusions : The performances of One-step Real-Q ApoE genotyping and Seeplex ApoE ACE genotyping were comparableoverall. However, the former showed better sensitivity and specificity comparable with those of sequencing. Hence, One-stepApoE genotyping could be a faster and more accurate option for ApoE genotyping.

Human brucellosis is an important zoonotic disease and has a wide clinical spectrum. Nonspecific hematologic abnormalities related to brucellosis are frequently found, but pancytopenia is uncommon. Malignant diseases have been infrequently reported as a rare cause of pancytopenia in patients with brucellosis. We describe a patient with brucellosis and pancytopenia who was later diagnosed with acute myeloid leukemia. A 71-yr-old man was admitted to a hospital with fever and pancytopenia. Brucella was cultured from blood, and the bone marrow findings were in accordance with brucellosis. The patient's clinical symptoms improved; however, he still showed pancytopenia after completion of medical treatment. After approximately 6 months, he was readmitted with pneumonia and pancytopenia. The second bone marrow examination revealed hypercellular marrow with increased number of blasts. The chromosome analysis showed 46,XY,trp(8)(q11.2q22)[8]/46,idem,del(7)(q22)[12]. The patient was diagnosed with acute myeloid leukemia with myelodysplasia-related changes. He refused further evaluation and therapy, and subsequently died while receiving conservative treatment.