BACKGROUND: There are many reports showing the efficacy of polymerase chain reaction(PCR) for the diagnosis of Mycobacterium tuberculosis in sputum. but only few reports in extrapulmonary specimens. Because of the difficulty in establishing a diagnosis of tuberculosis in the extrapulmonary specimens there have been considerable interest in the development of a rapid sensitive diagnostic test that might be useful. Therefore we used PCR for detection of M. tuberculosis DNA in extrapulmonary specimens and compared the results of conventional acid-fast stain, culture methods and PCR assay. METHODS: Total of 63 clinical samples(10 cerebrospinal fluids, 12 pleural fluids, 1 pericardial fluid, 3 bone marrow aspirates, 1 ascitic fluid, 25 fine needle aspirates of lymph nodes, 7 urine, 1 stool and 3 tissue biopsies) in Ewha Womans University Tongdaemun hospital were analysed by the PCR. We performed the PCR using a species-specific M. tuberculosis DNA fragment(mtp 40 gene) as primers that was cloned and sequenced at recent and a 396-bp fragment was specifically amplified. We analyzed sensitivity and specificity of AFB culture and PCR for the diagnosis of extrapulomonary tuberculosis. RESULTS: The positivity of AFB smear, culture and PCR were 2(10%), 4(20%), 13(65%) out of total 20 cases diagnosed as clinically active extrapulmonary tuberculosis. respectively. All of 2 smear-positive samples and 2 of 4 culture-positive and smear-negative samples were PCR-positive. And 9 of 14 smear and culture negative specimens also gave detectable DNA products in PCR The specificity of PCR(95.4%) is compared with those of smear and culture(100.0%). CONCLUSIONS: This results suggest that the PCR assay is a sensitive and rapid diagnostic alternative to classical procedures for the diagnosis of extrapulmonary tuberculosis.
Ascitic Fluid ; Bone Marrow ; Cerebrospinal Fluid ; Clone Cells ; Diagnosis* ; Diagnostic Tests, Routine ; DNA ; Female ; Humans ; Lymph Nodes ; Mycobacterium tuberculosis ; Needles ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Sputum ; Tuberculosis*

BACKGROUND: Endothelial adhesion molecule expression induced by pro-inflammatory cytokine plays an important role in vascular endothelial cell injury, leading to vascular disease. Allium tuberosum (AT), which is used as a functional food, has a thrombolytic effect. It contains vitamin A, vitamin C, carbohydrate, calcium, iron, and phosphorus. There are many carotenes that turn into vitamin A in the body. Also, it helps blood circulation and stimulates metabolism. The purpose of the this study was to estimate the anti-inflammatory effects of the AT extract. METHODS: Human vascular endothelial cells were pre-treated with 100 μg/mL AT extract for 30 minutes and subsequently co-treated with TNF-α (10 ng/mL) and AT extract (100 μg/mL) for 1, 4, and 6 hours. After treatment, the cells were lysed and used for quantitative reverse transcription PCR, Western blot analysis, and monocyte adhesion assay. RESULTS: We examined the effect of the AT extract on inflammatory gene expression in TNF-α-induced human umbilical vein endothelial cells (HUVECs). The extract reduced the expression levels of mRNA and protein of intercellular adhesion molecule (ICAM)-1 and vascular cell adhesion molecule (VCAM)-1 in TNF-α-stimulated HUVECs. It also inhibited the TNF-α-induced phosphorylation of the NF-κB p65 subunit and degradation of IκBα. Furthermore, the AT extract prevented the increased adhesion capacity of monocyte to TNF-α-stimulated vascular endothelial cells by reducing ICAM-1 and VCAM-1 expression. CONCLUSIONS: The AT extract has preventive and anti-inflammatory effect against vascular disease and has potential for supporting prevention against the early process of atherosclerosis.
Allium* ; Ascorbic Acid ; Atherosclerosis ; Blood Circulation ; Blotting, Western ; Calcium ; Carotenoids ; Chive* ; Endothelial Cells* ; Functional Food ; Gene Expression ; Human Umbilical Vein Endothelial Cells ; Humans* ; Inflammation* ; Intercellular Adhesion Molecule-1 ; Iron ; Metabolism ; Monocytes ; Necrosis* ; NF-kappa B ; Phosphorus ; Phosphorylation ; Polymerase Chain Reaction ; Reverse Transcription ; RNA, Messenger ; Vascular Cell Adhesion Molecule-1 ; Vascular Diseases ; Vitamin A

This study was conducted to evaluate the relationship between change in obesity indices and change in serum lipids in adult male workers. Two-hundred-eight adult male workers of an industry in Taegu city were followed-up from 1991 to 1995. Height, weight, circumferences of hip and waist, blood pressure were measured and serum lipids were analysed. Data on life style were obtained using self-administered questionnaires. Mean differences of anthropometric measurements between 1991 and 1995 were as follows; 1.63kg in weight, 3.61cm in waist circumferences, 4.23cm in hip circumferences, 0.52kg/m2 in BMI and -0.021 in WHR. Those of lipids were as follows; 15.09mg/dl in total cholesterol, 20.43mg/dl in triglyceride, 9.40mg/dl in HDL-cholesterol, 2.87 in MI-index(p<0.01) and 350mg/dl in LDL-cholesterol. The changed value of BMI and Katsura index were strongly correlated with that of total cholesterol(r=0.174, p<0.05), the changed value of BMI correlated with that of triglyceride(r=0.374, p<0.01) and the changed value of weight correlated with that of MI index(r=-0.173, p<0.05). The changed value of WHR was significantly correlated with that of total cholesterol(r=0.162, p<0.05), however, was not significantly correlated with HDL-cholesterol, LDL-cholesterol, triglyceride and MI index. The changed value of weight, BMI and Katsura index were correlated with that of triglyceride(r=0.262, p<0.01; r=0.267, p<0.01; r=0.258, p<0.01) and the changed value of MI index(r=-0.143, p<0.05; r=-0.158; r=-0.144, p<0.01), adjusting the pattern of change in life style. The changed values of HDL-cholesterol and MI index between 1991 and 1995 in low WHR group were significantly higher than those in high WHR group(p<0.05, p<0.01), adjusting the baseline value of them. Similar pattern was observed when considering Katsura index. When stratifying by BMI value of 1991, in low BMI group, the changed value of HDL-cholesterol and MI index showed the same pattern as above, however the of triglyceride was statistically higher in obese group than in non obese group(p<0.05). In conclusion BMI might be a better indicator to predict serum lipids change than other obesity indices.
Adult* ; Blood Pressure ; Cholesterol ; Daegu ; Hip ; Humans ; Life Style ; Male* ; Obesity* ; Surveys and Questionnaires ; Triglycerides ; Waist Circumference

No abstract available.
Cesarean Section, Repeat* ; Female ; Fistula*

An ectopic thyroid occurs when thyroid tissue has not properly migrated from the foramen cecum to the fourth tracheal ring along the midline of the ventral portion of the neck, but instead is located elsewhere. There are some cases of dual-site ectopic thyroid glands, usually involving adolescents or adults. Cases of neonatal dual ectopic thyroid glands are even rarer. We report a case of a dual ectopic thyroid with congenital hypothyroidism found during a neonatal screening of the lingual and upper cervical regions of a patient . The patient had no airway obstruction symptoms, such as dysphagia or grunting. The thyroxine (T4) level was 2.49 microg/dL (normal value: 6.2-22.0 microg/dL) and the thyroid-stimulating hormone (TSH) level was 217.85 microIU/mL (normal value: 1.7-9.1 microIU/mL). A dual ectopic thyroid was diagnosed based on a Tc-99m thyroid scan. After receiving thyroid hormone replacement therapy, the child has developed normally.
Adolescent ; Adult ; Airway Obstruction ; Cecum ; Child ; Congenital Hypothyroidism ; Deglutition Disorders ; Hormone Replacement Therapy ; Humans ; Infant, Newborn ; Neck ; Neonatal Screening ; Thyroid Dysgenesis ; Thyroid Gland ; Thyrotropin ; Thyroxine

Neonatal hemochromatosis is a very rare disorder with an unclear etiology with an extremely poor outcome. We report a case of female newborn who presented with direct hyperbilirubinemia without any evidence of congenital infection, immune related hemolysis or exogenous iron uptake. Diagnostic studies revealed highly elevated ferritin level. T2 weighted image of abdominal Magnetic Resonance Imaging (MRI) showed decreased signal intensity of entire left lobe and a part of right lobe of liver with normal spleen. Liver biopsy showed a large amount of hemosiderin in the hepatocytes and Kupffer cells. All the biochemical and excretory liver functions normalized with conservative managements.
Biopsy ; Female ; Ferritins ; Hemochromatosis* ; Hemolysis ; Hemosiderin ; Hepatocytes ; Humans ; Hyperbilirubinemia ; Infant, Newborn ; Iron ; Kupffer Cells ; Liver ; Magnetic Resonance Imaging ; Spleen

Gastritis cystica polyposa (GCP) is a lesion characterized by all the histological features described for hyperplastic polyps, And there is s marked proliferation of muscular elements and entrapment of numerous epithelial cysts. These lesions have been described at gastroenterostomy stomas, at peptic ulcer edges, and in association with carcinoma. It is rare that GCP presenting as a submucosal tumar-like lesion develops in the absence of above mentioned associated conditions. We had experienced a 69 year-old man with GCP. Barium X-ray and endoacopic findings showed submucosal tumor in antrum, and endoscopic ultrasonograpic findings showed markedly thickened mucosal layer with scattered hypoechoeic areas and the submucosal layer well preserved. GCP was confirmed by histological examination of resected stomach.
Aged ; Barium ; Gastritis* ; Gastroenterostomy ; Humans ; Peptic Ulcer ; Polyps ; Stomach

PURPOSE: The purpose of this study is to evaluate the knowledge and attitudes of oncology ward nurses toward cancer pain management and to find ways to improve the educational program for nurses. METHOD: A total of 209 nurses working at the oncology ward of three hospitals in Seoul and a Gyenggi Province. The survey instrument used was the 32-item scale for evaluating nurses knowledge and attitudes originally developed by McCaffery and Ferrell'(1990), that was by Kim'(1997). RESULTS: In terms of the nurses knowledge of pain management, the result showed that the nurses scored an average of 67.8 out of 100 for phamacokinetics of opioids, 84.8 for classification of analgesics, 60.1 for pain assessment, and 70.7 for drug administration. 18.2% of the nurses hesitate to inject the narcotic agent because of concerns regarding the drug's potential side effects. there was significant difference in the knowledge of pain management according to the general characteristics of pain in terms of the nurses age(p=.001), position (p=.016), years of experiences(p=.002), experience of cancer pain education(p=.001). CONCLUSION: The also showed that nurses working at cancer ward lack knowledge. It is important to provide intensive education to nurses about cancer pain management.
Analgesics ; Analgesics, Opioid ; Classification ; Education ; Pain Management* ; Pain Measurement ; Seoul

PURPOSE: The purpose of this study is to evaluate the knowledge and attitudes of oncology ward nurses toward cancer pain management and to find ways to improve the educational program for nurses. METHOD: A total of 209 nurses working at the oncology ward of three hospitals in Seoul and a Gyenggi Province. The survey instrument used was the 32-item scale for evaluating nurses knowledge and attitudes originally developed by McCaffery and Ferrell'(1990), that was by Kim'(1997). RESULTS: In terms of the nurses knowledge of pain management, the result showed that the nurses scored an average of 67.8 out of 100 for phamacokinetics of opioids, 84.8 for classification of analgesics, 60.1 for pain assessment, and 70.7 for drug administration. 18.2% of the nurses hesitate to inject the narcotic agent because of concerns regarding the drug's potential side effects. there was significant difference in the knowledge of pain management according to the general characteristics of pain in terms of the nurses age(p=.001), position (p=.016), years of experiences(p=.002), experience of cancer pain education(p=.001). CONCLUSION: The also showed that nurses working at cancer ward lack knowledge. It is important to provide intensive education to nurses about cancer pain management.
Analgesics ; Analgesics, Opioid ; Classification ; Education ; Pain Management* ; Pain Measurement ; Seoul

No abstract available.
Humans