No abstract available.
Rabbits*

BACKGROUND: Moxifloxacin is an 8-methoxyquinolone compound which has been shown to have the best activity of the quinolones against M. tuberculosis but there is no literature showing the rate of cross-resistance between moxifloxacin and the other quinolones such as ofloxacin. Therefore, we tested the activity of moxifloxacin against ofloxacin resistant M. tuberculosis by a study of cross-resistance. METHODS: We tested MIC's of moxifloxacin and ofloxacin by proportion method against 34 M. tuberculosis isolates showing resistance against ofloxacin at 2.5microgram/ml concentration and 13 ofloxacin susceptible isolates from specimens submitted to clinical laboratory of National Masan Hospital from March 2003 to March 2004. RESULTS: For ofloxacin susceptible isolates, MIC(50) and MIC(90) of ofloxacin were all 1.25 microgram/ml, and MIC(50) and MIC(90) of moxifloxacin were 0.31 microgram/ml and 0.63microgram/ml respectively. For ofloxacin resistant isolates, MIC(50) of ofloxacin was over 10microgram/ml and MIC(50) of moxifloxacin was 5microgram/ml,MIC(90) of ofloxacin and moxifloxacin were all over 10microgram/ml. The rate of cross-resistance between the two was 67.6%(23/34) at 2.5microgram/ml concentration. CONCLUSIONS: Moxifloxacin showed activity against 82.4%(28/34) of ofloxacin resistant M. tuberculosis at 10microgram/ml, but more studies are needed so that moxifloxacin will be used for patient with multi-drug resistant tuberculosis including ofloxacin resistance.
Humans ; Mycobacterium tuberculosis* ; Mycobacterium* ; Ofloxacin* ; Quinolones ; Tuberculosis ; Tuberculosis, Multidrug-Resistant

BACKGROUND: Despite the emerging danger of MDR-TB to human beings, there have only been a limited number of drugs developed to treat MDR-TB since 1970. This study investigated the cross-resistance rate between rifampicin (RFP) and rifabutin (RBU) in order to determine the efficacy of rifabutin in treating MDR-TB. In addition, the results of rifabutin were correlated with the rpoB mutations, which are believed to be markers for MDR-TB and RFP resistance. METHODS: The MICs of RBU were tested against 126 clinical isolates of MDR-TB submitted to the clinical laboratory of National Masan TB Hospital in 2004. Five different concentrations (10-160 microgram/ml) were used for the MICs. The detection of the rpoB mutations was performed using a RFP resistance detection kit with a line probe assay(LiPA), which contains the oligonucleotide probes for 5 wide type and 3 specific mutations (513CCA, 516GTC, and 531TTG). The rpoB mutation was determined by direct sequencing. RESULTS: The rate of cross-resistance between RFP and RBU was 70.5%(74/105) at 20 microgram/ml RBU(ed note: How much RFP?) Most mutations (86.3%) occurred in the 524~534 codons. The His526Gln, His526Leu, Leu533Pro, Gln513Glu, and Leu511Pro mutations(Ed note: Is this correct?) were associated with the susceptibilty to RBU. CONCLUSION: Based on the cross-resistance rate between RFP and RBU, RBU may be used effectively in some MDR-TB patients. Therefore, a conventional drug susceptibility test for RBU and a determination of the critical concentration are needed. However, rpoB gene mutation test may be have limited clinical applications in detecting RBU resistance.
Codon ; Humans ; Oligonucleotide Probes ; Rifabutin* ; Rifampin*

BACKGROUND: The last national tuberculosis survey was carried out in 1995. In 2000, the KTBS(Korean Tuberculosis Surveillance System) replaced a previous national survey. However, the KTBS does not show some of the important epidemiological indexes such as the prevalence of positive tuberculosis or the drug resistance rate. The aim of this study was to compare the clinical features of pulmonary tuberculosis patients admitted to a national tuberculosis hospital in 1995 and 2002. From this study, the authors expect to estimate the trend of the clinical features of tuberculosis in Korea even though it can not represent the Korean tuberculosis situation as a whole. METHOD: A cross sectional analysis of the clinical features for 331 pulmonary tuberculosis in-patients admitted to the National Masan Tuberculosis Hospital as of Dec. 2002, was carried out and these results were compared with those reported in 1995. RESULTS: In comparison with the data reported in 1995, the mean age was increased by 3.6 years (44.1+/-14.6 vs 47.7+/-16.4, p<0.01). The number of past tuberculosis history and used anti-tuberculous drugs prior to admission decreased from 2.0+/-1.7 and 6.1+/-2.3 to 1.7+/-1.8 and 4.6+/-3.6(p<0.05, p<0.001), respectively. While the resistance rate for anti-tuberculous drugs was similar (81.0% vs 77.6%), the initial resistance rate(10.5% vs 21.4%) and initial MDR rate(2.4% vs 16.5%) increased significantly(p=0.012, p=0.001, respectively). In 1995, the public health communities were in charge of approximately 65% of newly diagnosed tuberculosis cases, but this reduced to 40.5% in 2002(p<0.001). CONCLUSION: The existing national TB program (NTP) needs to be revised and strengthened in order to cope with the unfavorably changing situation of the domestic TB problem because the number of TB patients has not decreased and the initial resistance rate has increased greatly. Furthermore, the public and private sectors should cooperate each other to control the TB problem effectively because the private sector is now managing more than half of the TB patients.
Cross-Sectional Studies ; Drug Resistance ; Hospitals, Chronic Disease* ; Humans ; Korea ; Observational Study* ; Prevalence ; Private Sector ; Public Health ; Tuberculosis* ; Tuberculosis, Pulmonary*

PURPOSE: T cells play a central role in cell-mediated immunity, atopic disease, and asthma. The balance of CD28/cytotoxic T-lymphocyte antigen 4 (CTLA4)-derived signal transduction plays an important role in the activation of T cells and an increased immunoglobulin E (IgE) response. The aim of the current study was to investigate the association between polymorphisms in the genes encoding both CTLA4 and the high-affinity IgE receptor 1B (FCER1B) and serum IgE levels in Korean children with asthma. METHODS: We enrolled 238 controls and 742 children with asthma. The CTLA4 +49A/G and FCER1B -654C/T polymorphisms were genotyped by PCR-restriction fragment length polymorphism analysis. RESULTS: We observed no difference in the distribution of CTLA4 +49A/G among controls, children with asthma, and those with atopic asthma. In contrast, the GA genotype of CTLA4 +49A/G in children with atopic asthma was significantly higher compared to that in those with non-atopic asthma. Moreover, significantly higher log Dp/Df-specific IgE levels were found in children with asthma and those with atopic asthma carrying one or two copies of the CTLA4 +49A versus those homozygous for +49G. Gene-gene interactions between CTLA4 and FCER1B with the heterozygote and homozygote of variant genotypes were associated with the log Dp/Df-specific IgE levels, but not asthma development. In addition, children with Dp/Df (+) asthma carried an elevated combined genotype of risk allele compared to those with Dp/Df (-) asthma. CONCLUSIONS: The CTLA4 +49A/G polymorphism may contribute to the production of IgE in Korean children with asthma, especially in Dp/Df-specific IgE levels, but not in the direct development of asthma. In addition, Dp/Df-specific IgE levels with a FCER1B -654C/T polymorphism may involve additive effects.
Alleles ; Asthma ; Child ; Coat Protein Complex I ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Genotype ; Heterozygote ; Homozygote ; Humans ; Immunity, Cellular ; Immunoglobulin E ; Immunoglobulins ; Lifting ; Signal Transduction ; T-Lymphocytes

PURPOSE: T cells play a central role in cell-mediated immunity, atopic disease, and asthma. The balance of CD28/cytotoxic T-lymphocyte antigen 4 (CTLA4)-derived signal transduction plays an important role in the activation of T cells and an increased immunoglobulin E (IgE) response. The aim of the current study was to investigate the association between polymorphisms in the genes encoding both CTLA4 and the high-affinity IgE receptor 1B (FCER1B) and serum IgE levels in Korean children with asthma. METHODS: We enrolled 238 controls and 742 children with asthma. The CTLA4 +49A/G and FCER1B -654C/T polymorphisms were genotyped by PCR-restriction fragment length polymorphism analysis. RESULTS: We observed no difference in the distribution of CTLA4 +49A/G among controls, children with asthma, and those with atopic asthma. In contrast, the GA genotype of CTLA4 +49A/G in children with atopic asthma was significantly higher compared to that in those with non-atopic asthma. Moreover, significantly higher log Dp/Df-specific IgE levels were found in children with asthma and those with atopic asthma carrying one or two copies of the CTLA4 +49A versus those homozygous for +49G. Gene-gene interactions between CTLA4 and FCER1B with the heterozygote and homozygote of variant genotypes were associated with the log Dp/Df-specific IgE levels, but not asthma development. In addition, children with Dp/Df (+) asthma carried an elevated combined genotype of risk allele compared to those with Dp/Df (-) asthma. CONCLUSIONS: The CTLA4 +49A/G polymorphism may contribute to the production of IgE in Korean children with asthma, especially in Dp/Df-specific IgE levels, but not in the direct development of asthma. In addition, Dp/Df-specific IgE levels with a FCER1B -654C/T polymorphism may involve additive effects.
Alleles ; Asthma ; Child ; Coat Protein Complex I ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Genotype ; Heterozygote ; Homozygote ; Humans ; Immunity, Cellular ; Immunoglobulin E ; Immunoglobulins ; Lifting ; Signal Transduction ; T-Lymphocytes

BACKGROUND: Para-aminosalicylic acid(PAS) is a 2nd-line drug that can cause severe adverse reactions leading to poor patient compliance. This study evaluated the relapse rate according to the discontinuance of PAS at a certain point after bacteriological conversion during the course of chemotherapy for multidrug-resistant tuberculosis(MDR-TB). METHODS: 42 out of 452 MDR-TB patients were enrolled in this study. All subjects were receiving chemotherapy including PAS at National Masan TB Hospital between Jan. 1, 2000 and Dec. 31, 2001. The relapse rate was evaluated after the discontinuance of PAS from their initial regimen as a result of the severe adverse reactions at a certain point after the bacteriological conversion during the course of chemotherapy for MDR-TB. RESULTS: The male to female ratio was 2.5:1, and the mean age was 47.2 years old. The average number of past histories, used drugs and resistant drugs was 1.2, 3.9 and 4.3. The mean number of sensitive drugs included in the inirial regimen was 3.9. The mean time for bacteriological conversion and discontinuance of the PAS was 2.3 months after initiating treatment and 6 months after bacteriological conversion, respectively. There was no relapse after discontinuing PAS during a mean follow up period of 31.6 months. CONCLUSION: PAS may be discontinued in the cases of serious gastrointestinal problems approximately 6 months after bacteriological conversion without concern about relapse.
Compliance ; Drug Therapy* ; Female ; Follow-Up Studies ; Humans ; Male ; Patient Compliance ; Recurrence* ; Retrospective Studies* ; Tuberculosis, Multidrug-Resistant

Cervical epidural steroid injection is frequently used in the conservative management of neck pain and cervical radiculopathy. Epidural cervical transforaminal injections are usually well-tolerated with mild side effects such as transient decreased sensory and motor function, or headache due to dural puncture. Although there are a few case reports about adverse effects of cervical epidural injection in the literature, it can cause severe complications such as large hematoma, infarction by spinal vascular injury. Subdural hematoma has been occurred much less common rather than epidural hematoma in the spinal cord. We report a rare catastrophic case of cervical spinal subdural hematoma with quadriparesis after cervical transforaminal epidural block.
Headache ; Hematoma ; Hematoma, Subdural* ; Hematoma, Subdural, Spinal ; Infarction ; Injections, Epidural ; Neck Pain ; Punctures ; Quadriplegia* ; Radiculopathy ; Spinal Cord ; Vascular System Injuries

PURPOSE: To evaluate the minimum 5-year mid-term clinical and radiological results of minimally invasive surgery total knee arthroplasty (MIS-TKA) using a mini-keel modular tibia component. MATERIALS AND METHODS: We retrospectively evaluated 254 patients (361 cases) who underwent MIS-TKA between 2005 and 2006. The latest clinical and radiological assessments were done in 168 cases that had been followed on an outpatient basis for more than 5 postoperative years. Clinical results were assessed using the Hospital for Special Surgery (HSS) score and Knee Society score. Radiological evaluation included measurements of knee alignment. RESULTS: The average postoperative knee range of motion and HSS score were 134.3degrees+/-12.4degrees and 92.7degrees+/-7.0degrees, respectively. The average postoperative femorotibial angle and tibial component alignment angle were 5.2degrees+/-1.7degrees valgus and 90.2degrees+/-1.6degrees, respectively. The average tibial component posterior inclination was 4.8degrees+/-2.1degrees. The percentage of cases with tibial component alignment angle of 90degrees+/-3degrees was 96.1%, and that with the femorotibial angle of 6degrees+/-3degrees valgus was 94.0%. Radiolucent lines were observed in 20 cases (12.0%): around the femur, tibia, and patella in 14 cases, 10 cases, and 1 case, respectively. However, they were less than 2 mm and non-progressive in all cases. The survival rate was 99.4% and there was no implant-related revision. CONCLUSIONS: MIS-TKA using a mini-keel modular tibial plate showed satisfactory results, a high survival rate, and excellent clinical and radiological results in the mid-term follow-up.
Arthroplasty ; Femur ; Follow-Up Studies ; Humans ; Knee ; Outpatients ; Patella ; Range of Motion, Articular ; Retrospective Studies ; Surgical Procedures, Minimally Invasive ; Survival Rate ; Tibia

No abstract available.
Ovarian Neoplasms* ; Survival Analysis*