BACKGROUND: Tuberculosis continues to be a major threat to health throughout the world, with an estimated 8 to 10 million new cases and 3 million deaths annually. And control of the disease is further threatened by the emergence of drug resistance. Recent major advances have been made in unravelling the molecular basis of M. tuberculosis resistance to isoniazid, streptomycin, quinolones and rifampin. And rifampin resistance is the useful indicator for the occurance of the multi-drug resistance. Hence, the rapid detection of rifampin resistant strain of M. tuberculosis is the key to have successful anti-tuberculosis therapy. Here we present our experience using PCR and line probe assay (INNO-LiPA) for easy and rapid detection of rifampin resistance of M. tuberculosis. METHODS: Thirty rifampin resistant and twenty susceptible strains of M. tuberculosis were collected from the routine culture and analyzed with INNO-LiPA. And results were compared with conventional antibiotic susceptibility testing. After amplification of the region of the RNA polymerase(rpoB), the amplified product is hybridized with a set of 10 oligonucleotides immobilized onto a membrane strip. From the pattern obtained the presence or not of rifampin resistance M. tuberculosis can be assessed. RESULTS: Ninety three percent of patients who had rifampin resistant strain revealed the multidrug resistance while only two showed resistance to rifampin only. The INNO-LiPA test results were generally agreeable with that of the conventional susceptibility testing(90%). The mutations in codon 531 (absence of 55 probe) were most commonly observed. In 55.2% of the 31 rifampin resistance M. tuberculosis confirmed on mutation by R-probes on the INNO-LiPA strips. CONCLUSIONS: The line probe assay after polymerase chain reaction is a fast and convenient method to detect both presence of M. tuberculosis complex strains and its resistance to rifampin in clinical specimens. We have suggested that detection of rifampin resistance may play a key role in monitoring multi-drug resistance. Consequently, the INNO-LiPA test may constitute an important tool for the control of tuberculosis.
Codon ; Drug Resistance ; Drug Resistance, Multiple ; Humans ; Isoniazid ; Membranes ; Mycobacterium tuberculosis* ; Mycobacterium* ; Oligonucleotides ; Polymerase Chain Reaction ; Quinolones ; Rifampin* ; RNA ; Streptomycin ; Tuberculosis

No abstract available.

No abstract available.

Digital mucous cysts encompass two pathogenetically distinct entities, the cutaneous myxomatous type and ganglion type. We describe an 8-year-old boy with a digital mucous cyst on the ventral side of the proximal phalanx of the right fifth finger. The case shows characteristic histopathological findings, but in an unusual location.
Child ; Fingers ; Ganglion Cysts ; Humans ; Male

We describe a 38-year-old woman with an adenoma of anogenital mammary-like glands on the left labium major. Adenomas of anogenital mammary-like glands have been rarely reported with various nomenclatures in the English literature. The knowledge of this rare disease entity may be important to diagnose and treat the lesions arising on the anogenital areas.
Adenoma* ; Adult ; Female ; Humans ; Rare Diseases

BACKGROUND: Porokeratosis is a disorder of epidermal keratinization which is characterized by the presence of cornoid lamellae. Since the original description of the plaque form of Mibelli, various types of porokeratosis have been reported. OBJECTIVES: The purposes of this study were aimed at evaluating the clinical and biological features of porokeraosis. METHODS: The hospital charts and slides of 29 patients with porokeratosis were reviewed. Only the cases showing characteristic cornoid lamellae by histopathological examinations were included. RESULTS: Female patients outnumbered the male ones (M:F = 1:2.2). Ages of the onset of porokeratosis varied from infancy to 68 years. Disseminated superficial actinic porokeratosis (DSAP) was the predominant type (22 cases). The Mibelli type was seen in 3 cases and the linear type in 4 cases. Only one case had a family history of porokeratosis. Two patients had complained of pruritus in the lesions, which were the DSAP and linear type, respectively. In that linear type, squamous cell carcinoma developed. Eight patients had other associated diseases. Although 6 patients were treated with CO₂ laser, topical isotretinoin or cryotherapy, the lesions tended to recur, persist or even progress. CONCLUSIONS: Porokeratosis showed various clinical features. DSAP was the predominant type. Two patients complained of itching of the lesions, which were the DSAP and linear types, respeciively. Within that linear type, squamous cell carcinoma developed. We speculate that pruritus might be an ominous sign of malignant transformation of the porokeratosis. We suggest that the Mibelli type and linear type of porokeratosis should be either excised or destroyed, or in widespread cases close follow-up should be mandatory.
Carcinoma, Squamous Cell ; Cryotherapy ; Female ; Follow-Up Studies ; Humans ; Isotretinoin ; Male ; Porokeratosis* ; Pruritus

The purpose of this study was to develop and test the validity of standardized Korean nomenclature of the Home Health Care Classification(HHCC), developed by Saba at the University of Georgetown. The four phases of the study were : (1) Two professors and 15 graduate students, who were taking a nursing intervention course, translated the HHCC into Korean. (2)12 nurses with various clinical backgrounds reviewed each nomenclature taking into consideration of the definition and activities, and the Delphi method was used to determine the best appropriate nomenclature for each term; (3)20 academic and clinical experts in nursing were given a questionnaire to rate the validity of each Korean nomenclature using a 5 point Likert scale ranging from very inappropriate to very appropriate; (4) Five members of the Korean Nurses Association Research Committee reviewed the survey results and determined the most appropriate Korean nomenclature for each term of the HHCC. Most of the nomenclatures had a score of more than 4.0, but several terms had a score lower than 4.0. They are Ambulation therapy(3.1.1), Anticipatory grieving(3.11), Sexual patterns alteration(3.17), Nursing care coordination(3. 22), Physical therapist service(3.22), Regular diet(3.33), and Instrumental activities of daily living(3.44). These research results will be included in the nursing vocabulary dictionary to be published by the Korean Nurses Association.
Classification* ; Delivery of Health Care* ; Humans ; Nursing ; Nursing Care ; Physical Therapists ; Vocabulary ; Walking ; Surveys and Questionnaires

Nursing Diagnosis has evolved in the guest to define nursing and its functions. But for the application to clinical practice an unified system of terminology that help nurses to assess selected data and identify potential or actual client problems is required. Consistent terminology that captures the real meanings of the nursing diagnosis makes oral and written communication more accurate and efficient. Already we had performed to deliver a Korean -translated version of the 98 nursing diagnoses through the process of content validity tests and translations, and additionally performed to deliver a Korean-translated version of another 17 nursing diagnoses. The list of 17 nursing diagnoses were reviewed by our research team and two linguists, one specialized in Korean and the other in English. 17 diagnoses were mailed to 719 subjects to test content validity from December 10, 1997 to January 24, 1998, Among 719 questionnaires, 185 were used for analysis. Total mean score of the diagnoses was 3.72 on the 5 point likert scale. The diagnoses that acquired less than 3.50 were 'Risk for altered parent/infant/child attachment'(3.28), 'Potential for enhanced organized infant behavior'(3.40), 'Potential for enhanced community coping' & 'Risk for disorganized infant behavior'(3.49). We suggest to conduct tests for validation of related factors and characteristics of these 17 Nursing Diagnosis.
Diagnosis ; Humans ; Infant ; Nursing Diagnosis* ; Nursing* ; Postal Service ; Translations ; Surveys and Questionnaires

No abstract available.
Writing

Vecuronium has been used for long surgical procedure by infusion or intermittent injection. However, such methods are not economical. It may be that the use of longer acting pancuronium followed by vecuronium would offer the advantages of economy and rapid recovery. The aim of this study was to investigate the duration of effect of vecuronium administered after pancuronium. Eighteen patient reguiring prolonged major surgery were given intravenous pancuronium 0.06 mg/ kg (ED95) after induction of anesthesia and a dose of pancuronium 0.06 mg/kg (Group I, nine patients) or vecuronium 0.01 mg/kg (Group II, nine patients) was given at the recovery of neuromuscular transmission where the response to the first stimulus (T1) was 25% of control response. As a result, the time of onset, recovery time of 25%, 50% and 75% of control response T1 and recovery index was to be shorter with vecuronium than with pancuronium. It is concluded that vecuronium administered at the end of surgery after pancuronium is effective for shorting the duration of recovery time.
Anesthesia ; Humans ; Pancuronium* ; Vecuronium Bromide*