BACKGROUND: Instead of hepatitis C virus (HCV) RNA test using RT-PCR, an enzyme immunoas-say for detection of HCV core protein as a simple, rapid method for the detection of HCV viremia has been developed recently. In this study, we investigated the usefulness of HCV core protein for the detection of HCV viremia by comparing the results of HCV RNA. METHODS: The study group included 71 patients; some of whom showed anti-HCV Ab. The HCV core protein assay was performed by enzyme immunoassay (Ortho Clinical Diagnostics, Raritan, NJ, USA). RESULTS: The concordance rate between HCV RNA and HCV core protein assay was 75%. Compared with the HCV RNA results, HCV core protein assay showed 50% sensitivity and 97% specificity. Among 17 patients whose results for HCV RNA were positive and those of HCV core protein were negative, all of them had anti-HCV Ab. CONCLUSIONS: Although the sensitivity of HCV core protein was not high in cases with anti-HCV Ab, the positive results for HCV core protein suggests the presence of HCV viremia. So, HCV core protein may be used as a simple and rapid method for detection of HCV viremia.
Hepacivirus ; Humans ; Immunoenzyme Techniques ; RNA ; Sensitivity and Specificity ; Staphylococcal Protein A ; Viremia*

BACKGROUND: Type and screen is recommended for efficient use of blood and reduction in workload in blood bank. Column agglutiation test is standardized and easy to perform, and provide clear and stable reactions that improve the interpretation of results. In this study, we compared column agglutination test(Ortho Diagnostic Systems Inc., USA) with conventional tube test and investigate its usefulness in irregular antibody screening and identification. METHODS: A total 182 samples were screened for irregular antibodies using column agglutination test and conventional tube test. And 18 patient's sera in which irregular antibodies previously screened by both tube and column agglutination tests were identified for irregular antibodies by tube and column agglutination tests. We compared the results of two tests. RESULTS: In the screening test, there was 96.7%(176/182) agreements between column agglutination test and conventional tube test. The column agglutination test showed stronger reactivity than tube test. In the irregular antibody identification, there was 88.8%(16/18) agreement between two tests and disagreement were seen in the identification of anti-P1 and anti-Leb antibodies. CONCLUSION: The results of column agglutination test are objective and superior to the conventional tube test in irregular antibody screening and identification tests. These results suggest that the column agglutination test will be useful and more convenient test in antibody screening and identification.
Agglutination Tests* ; Agglutination* ; Antibodies ; Blood Banks ; Mass Screening*

Allopurinol is widely used for chronic tophaceous gout as a uric acid lowering agent. Hypersensitivity to allopurinol occurrs in about 10% of patients, which limits the usage of allopurinol. The successful oral and intravenous desensitization of allopurinol has been reported worldwide since 1976. We recently experienced a 51-year-old male patient with gouty arthritis and hyperuricemia, who had previously experienced skin rash after allopurinol treatment. When allopurinol was retried, erythematous and foliative skin rash developed on entire body. Because allopurinol was essential in controlling hyperuricemia, the oral desensitization of allopurinol was tried. We report successful rapid oral allopurinol desensitization in the patient with chronic tophaceous gout, who exhibited exfoliative dermatitis as allopurinol hypersensitivity.
Allopurinol* ; Arthritis, Gouty ; Dermatitis, Exfoliative* ; Exanthema ; Gout ; Humans ; Hypersensitivity ; Hyperuricemia ; Male ; Middle Aged ; Uric Acid

BACKGROUND: Recently, we noticed an increased isolation rate for Candida tropicalis from urine of the patients in the intensive care unit (ICU) of the neurosurgery department in our hospital. We inves-tigated the risk factors for funguria and performed randomly amplified polymorphic DNA (RAPD) analysis for the isolates. METHODS: A total of 27 strains including 12 strains of C. tropicalis from the urine of ICU patients collected during a one-month period, 13 strains from other wards than ICU, and 2 control strains were analyzed. RAPD analysis was performed using 2 primers (UBC78 and CD16S). Medical re-cords of the patients were reviewed to determine the risk factors for funguria by C. tropicalis. RESULTS: RAPD analysis showed an identical pattern for all strains of C. tropicalis from ICU patients and a heterogeneous pattern for the isolates from other wards. C. tropicalis funguria of these ICU patients was significantly associated with the use of an urinary catheter (100%, P < 0.001), previous surgery (44%, P < 0.05) and trachostomy (40%, P < 0.05), when compared with those of non-ICU patients. CONCLUSIONS: The identical RAPD pattern of all C. tropicalis strains from ICU patients indicates that they possibly originated from one clone. Through the investigation of risk factors, we can postulate that an urinary catheter might be a source for the outbreaks of urinary tract infections in the ICU. In addition, RAPD analysis might be a very useful test as one of the molecular epidemiologic tools for C. tropicalis funguria.
Candida tropicalis* ; Candida* ; Clone Cells ; Disease Outbreaks ; DNA* ; Epidemiologic Studies* ; Humans ; Intensive Care Units ; Neurosurgery ; Risk Factors* ; Urinary Catheters ; Urinary Tract Infections* ; Urinary Tract*

Isolated extramedullary relapse of acute lymphoblastic leukemia (ALL) with sparing of the marrow after allogeneic stem cell transplantation is not common. We report a 32-year-old female patient with isolated ovarian relapse of T-cell ALL 18 months after allogeneic stem cell transplantation. She had no evidence of concomitant relapse in the bone marrow.
Adult ; Bone Marrow* ; Female ; Hematopoietic Stem Cell Transplantation* ; Humans ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence ; Stem Cell Transplantation ; T-Lymphocytes

BACKGROUND: Body fat distribution, rather than the level of obesity per se, appears to be a strong predictor of abnormalities in metabolic complication. Visceral fat accumulation is significantly correlated with glucose intolerance and constitutes as an independent risk factor for the diabetes mellitus. METHODS: We investigated the impact of body fat distribution on the glucose, lipid metabolism and growth hormone secretion in obese subjects with varying glucose tolerance and lean controls matched with sex and age. 69 obese Koreans (34 men, 35 women; 43.8 yrs) and 21 lean Koreans (10 men, 11 women; 40.8 yrs) were recruited. Anthropometric measurement and impedence for measurement of total body fat, and computed tomography for visceral and subcutaneous fat area at umbilicus level were performed. All subjects underwent a standard oral glucose tolerance test and GH stimulation test by L-dopa. RESULTS: The results are summarized as follows. 1. Obese patients had greater ideal body weight (%, IBW) and lean body mass (LBM) than lean controls. But no significant differences were found in IBW and LBM between 3 obese groups. 2. The 25 obese NIDDM had the highest FFA-AUC during OGTI and the lowest GH-AUC to L-Dopa stimulation test. The insulin-AUC during OGTT was the highest in 24 obese subjects with normal glucose tolerance. 3. All male groups have VSR of more than 0.4, which has been designated visceral fat obesity. In contrast all female groups have VSR of lesser than 0.4 but obese DM subjects have the highest VSR. Visceral fat area per body weight ratio(VWR) showed increasing tendency in obese, IGT, and DM group. 4. Waist circumference and VWR showed strong correlation with metabolic parameters among anthropometric parameters. They were positively correlated with FFA-AUC during OGTT and negatively correlated with GH-AUC to L-dopa stimulation. CONCLUSION: Visceral fat accumulation are associated with insulin resistance, dyslipidemia and impairment of growth hormone secretion via increase of free fatty acid. The simple waist circumference may provide a more practical indicator that correlated with aMominal fat distribution and metabolic complications associated with obesity.
Adipose Tissue* ; Body Fat Distribution ; Body Weight ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Dyslipidemias ; Female ; Glucose Intolerance ; Glucose Tolerance Test ; Glucose* ; Growth Hormone ; Humans ; Ideal Body Weight ; Insulin Resistance ; Intra-Abdominal Fat ; Levodopa ; Lipid Metabolism* ; Male ; Obesity* ; Risk Factors ; Subcutaneous Fat ; Umbilicus ; Waist Circumference

Although the papillary thyroid carcinoma generally follows an indolent course characterized by slow growth and abscence of distant metastasis, distant metastases to extrathyroid organ may occur in the lung, bone and brain in about 5% of patients. The lung metastases are usually diagnosed by plain X-ray, chest CT and 131I whole body scan. However, we present a case of papillary thyroid carcinoma with microscopic pulmonary metastasis that could not be detected by conventional method, such as chest X-ray, chest CT and 131I whole body scan. A 62-year-old female visited due to traumatic hemopneumothorax. In the pathology of resected tissues from lacerated lung parenchyme, metastatic papillary carcinoma was diagnosed without evidence of abnormality in radiologic examination and we diagnosed and treated an asymptomatic papillary thyroid carcinoma.
Brain ; Carcinoma, Papillary ; Female ; Hemopneumothorax ; Humans ; Lung ; Middle Aged ; Neoplasm Metastasis* ; Pathology ; Thorax ; Thyroid Gland* ; Thyroid Neoplasms* ; Tomography, X-Ray Computed ; Whole Body Imaging

Purpose: This study aimed to update the previously published nursing practice guideline for prevention of venous thromboembolism (VTE). Methods: The guideline was updated according to the manuals developed by National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN), and a Handbook for Clinical Practice Guideline Developer Version 10. Results: The updated nursing practice guideline for prevention of VTE was consisted of 16 domains, 46 subdomains, and 216 recommendations. The recommendations in each domain were: 4 general issues, 8 assessment of risk and bleeding factors, 5 interventions for prevention of VTE, 18 mechanical interventions, 36 pharmacological interventions, 36 VTE prevention starategies for medical patients, 25 for cancer patients, 13 for pregnancy, 8 for surgical patients, 7 for thoractic and cardiac surgery, 16 for orthopedic surgery, 10 for cranial and spinal surgery, 5 for vascular surgery, 13 for other surgery, 3 educations and information, and 2 documentation and report. For these recommendations, the level of evidence was 32.1% for level I, 51.8% for level II, and 16.1% for level III according to the infectious diseases society of America (IDSA) rating system. A total of 112 new recommendations were developed and 49 previous recommendations were deleted. Conclusion The updated nursing practice guideline for prevention of VTE is expected to serve as an evidence-based practice guideline for prevention of VTE in South Korea. It is recommended that this guideline will disseminate to clinical nursing settings nationwide to improve the effectiveness of prevention of VTE practice.

BACKGROUND: Combicin(R) is a new product of beta- lactam and beta-lactamase inhibitor combination which has antibacterial activity against aerobic and anaerobic bacteria, comprised of piperacillin and sulbactam. A phase III randomized clinical trial of Combicin(R) was done to evaluate and compare the efficacy and safety of piperacillin/sulbactam (Combicin(R)) with piperacillin in the treatment of urinary tract infection. METHODS: A total of 128 adult patients with acute urinary tract infection were enrolled and randomized into one of the two treatment groups during the period from August 1997 to September 1999 in Severance Hospital and Asan Medical Center, Seoul, Korea. Sixty-five patients were excluded in the analysis according to the exclusion criteria, and the rest 63 patients (3 men, 60 women) were eligible for the study. Clinical and bacteriologic responses were evaluated at entry and during the study period. Adverse effects were monitored by daily examination of the patients and periodic evaluations of laboratory findings. Statistical analyses were done by Chi-square test, Fisher's exact test, and Student t-test. RESULTS: Symptoms and signs such as fever, pyuria, dysuria, frequency, tenesmus, and costovertebral angle tenderness showed improvement in both group. Most commonly isolated microorganism was E. coli. The bacteriological eradication was found in 96.7% of the Combicin(R)-treated patients and in 90.9% of the piperacillin-treated patients. Adverse drug reactions in Combicin(R)-treated patients and piperacillin-treated patients occurred in 3.33% (2/60) and 5.88% (4/68) of the patients, respectively. Adverse events included liver function test elevation, drug fever, rash, indigestion, leukopenia, and nausea. Combicin(R) was well tolerated and side effects were negligible. CONCLUSION: Combicin(R) is safe and effective in the treatment of urinary tract infections.
Adult ; Bacteria, Anaerobic ; beta-Lactamases ; Chungcheongnam-do ; Drug-Related Side Effects and Adverse Reactions ; Dyspepsia ; Dysuria ; Exanthema ; Fever ; Humans ; Korea ; Leukopenia ; Liver Function Tests ; Male ; Nausea ; Piperacillin ; Pyuria ; Seoul ; Sulbactam ; Urinary Tract Infections* ; Urinary Tract*

Identified first by Lancefield and Hare in 1935, the group G streptococcus occurs as commensals in the skin, pharynx, intestine, and vagina. It has been reported to cause a variety of human infections, such as sepsis, endocarditis, peritonitis, pharyngitis, and infective arthritis. Group G streptococcus sepsis could occur in chronic states such as malignancy, diabetes, alcoholics, neurologic disease, cardiovarscular disease, and end stage renal disease, however, there has been only a few case reports of endogenous endopthalmitis caused by group G streptococcus. We report herein endogenous endopthalmitis caused by group G streptococcus sepsis in 64-year-old man of alcoholic.
Alcoholics ; Arthritis ; Endocarditis ; Endophthalmitis* ; Hares ; Humans ; Intestines ; Kidney Failure, Chronic ; Middle Aged ; Peritonitis ; Pharyngitis ; Pharynx ; Sepsis* ; Skin ; Streptococcus* ; Vagina