No abstract

The aim of this study was to describe the genetic diversity of Mycobacterium avium subsp. paratuberculosis (MAP) obtained from individual cows in Korea. Twelve MAP-positive fecal DNA samples and 19 MAP isolates were obtained from 10 cattle herds located in 5 provinces in Korea. In addition, 5 MAP isolates obtained from the Czech Republic and Slovakia and 3 isolates from Australia were genotyped for comparison with the domestic isolates. The most prevalent strains in Korea were of the “bison-type” genotype (23 of 31 fecal DNA/isolates) and were distributed nationwide. The remaining MAP isolates (8) and all of the foreign isolates were identified as “cattle-type”. The bison-type strains which were discriminated only as INMV 68 in variable-number tandem repeats of mycobacterial interspersed repetitive units (MIRU-VNTR) typing. Multilocus short sequence repeat (MLSSR) typing differentiated the bison-type strains into 3 different subtypes. The cattle-type strains were divided into 3 subtypes by MIRU-VNTR and 8 subtypes by MLSSR. The allelic diversities in the MIRU-VNTR and MLSSR results were calculated as 0.567 and 0.866, respectively. These results suggest that MIRU-VNTR typing cannot provide a sufficient description of the epidemiological situation of MAP. Therefore, an alternative method, such as MLSSR, is needed for typing of MAP strains to elucidate the molecular epidemiology of MAP infections. Overall, this study is the first epidemiological survey report in Korea using both MIRU-VNTR and MLSSR typing methods, and it has provided basic data necessary to elucidate the characteristics of MAP infections in Korea.

Rationale:Glossopharyngeal neuralgia (GPN) is a rare type of neuralgia. Depending on the cause, it is classified as idiopathic GPN and secondary GPN. Secondary GPN can also be caused by a mass effect or inflammation of the tonsils, the innervation area of glossopharyngeal nerve.Patient concerns:The patient was diagnosed idiopathic GPN 8 years ago. The patient had intermittent pain, but the pain was well controlled. From 5 months ago, the pain gradually worsened, the patient complained severe pain which impaired chewing and swallowing function.Diagnoses:Idiopathic GPN, secondary GPN, chronic tonsillitisInterventions:Percutaneous glossopharyngeal nerve block, glossopharyngeal neurolysis, and pulsed radiofrequency neuromodulation of glossopharyngeal nerve were performed. After the diagnosis of tonsillitis, antibiotic therapy was performedOutcomes:Two weeks after the antibiotic treatment, the pain decreased simultaneously with the patient's tonsillitis recovery.Lessons:In a Patient who had already been diagnosed with idiopathic GPN, both pain control and its cause should be considered when the pain is aggravated.