BACKGROUND: There are only a few studies regarding the causes of treatment failure for tuberculosis. Therefore, this study aimed to determine the causes of intractable tuberculosis. METHODS: M.tuberculosis, differentiated MOTT (Tycobacterium Other Than Tuberculosis) were isolated, and the RFLP (Restriction fragments length polymorphisms) pattern was analyzed from 204 patients with pulmonary tuberculosis and 53 suffering from neck tuberculosis. The IL-1β, IL-12, *1 IFNγ and *2 TNFαblood levels were measured. All patients were regularly followed for 18 months after treatment. RESULTS: There was no correlation between the RFLP patterns of M.tuberculosis treatment failure. From the 204 cases, 31.9% were intractable. The characteristics of patients with intractable tuberculosis were old age, being male and recurrent cases. The causes of treatment failure were identified as follows ; a decrease in the IL-12(59.4%) concentration, drug resistant strain(54.7%), irregular medication(15.4%), MOTT(6.2%) and a heavy infection(4.6%). The causes of all cases of intractable tuberculosis could be investigated. The IL-12 concentration in the blood was significantly lower in the intractable cases, where it disclosed a maximum sensitivity(64.7%) and specificity(75.4%) at 165.0 pg/ml. Most of the 53 cases on neck node tuberculosis were treated successfully. Therefore, we were unable to analyze the cause of treatment failure. CONCLUSION: A decrease in the blood IL-12 concentration and drug resistant strains were identified as the most significant causes of treatment failure for tuberculosis. In Korea, infection by clusters were prevalent, but no difference in the clinical course between clusters and non-clusters could be found.
Humans ; Interleukin-12 ; Korea ; Male ; Neck* ; Polymorphism, Restriction Fragment Length ; Treatment Failure* ; Tuberculosis* ; Tuberculosis, Pulmonary

PURPOSE: Ligament reattachment technique using a suture anchor appears to show satisfactory functional outcomes and mechanical stability compared with conventional bone tunnel technique. This study was prospectively conducted in order to evaluate functional outcomes of modified Brostrom procedures using the suture bridge technique for chronic ankle instability in athletes. MATERIALS AND METHODS: Twenty eight athletes under 30 years of age were followed for more than two years after undergoing the modified Brostrom procedure using the suture bridge technique. Functional evaluation consisted of the foot and ankle outcome score (FAOS), foot and ankle ability measure (FAAM) score. Range of motion and time to return to exercise were evaluated using a periodic questionnaire. Talar tilt angle and anterior talar translation were measured through stress radiographs for evaluation of mechanical stability. RESULTS: FAOS improved significantly from preoperative mean 59.4 points to 91.4 points (p<0.001). Daily living and sport activity scores of FAAM improved significantly from preoperative mean 50.5, 32.5 points to 94.8, 87.3 points, respectively (p<0.001). Talar tilt angle and anterior talar translation improved significantly from preoperative mean 16.8degrees, 13.5 mm to 4.2degrees, 4.1 mm at final follow-up (p<0.001). Times to return to exercise were as follows: mean 10.2 weeks in jogging, 15.4 weeks in spurt running, 13.1 weeks in jumping, 11.5 weeks in walking on uneven ground, 9.1 weeks in standing on one leg, 7.2 weeks in tip-toeing gait, 8.4 weeks in squatting, and 10.6 weeks in descending stairs. CONCLUSION: Modified Brostrom procedure using the suture bridge technique showed satisfactory functional outcomes for chronic ankle instability in athletes. Optimal indication and cost-effectiveness of the suture bridge technique will be studied in the future.
Ankle* ; Athletes* ; Follow-Up Studies ; Foot ; Gait ; Humans ; Jogging ; Leg ; Ligaments ; Prospective Studies ; Range of Motion, Articular ; Running ; Sports ; Suture Anchors ; Sutures* ; Walking ; Surveys and Questionnaires

OBJECTIVE: To evaluate the difference of coracohumeral ligament (CHL) thickness between asymptomatic shoulders and adhesive capsulitis. METHOD: Ultrasound examination was performed in 44 consecutive shoulders of 24 individuals (12 males and 12 females). Nine were diagnosed as adhesive capsulitis by clinical examination. We measured the maximum thickness of CHL. For CHL assessment, participants were scanned in sitting position with shoulder in maximal external rotation, elbow in 90 degrees flexion, forearm in neutral position, and hand in fist. The transducer was positioned between coracoid process and greater tuberosity of humerus. We used t test to compare the CHL thickness between asymptomatic and adhesive capsulitis and bivariate correlation analysis to assess a correlation between age and CHL thickness. RESULTS: There was a significant positive linear relationship between age and CHL thickness (p<0.01, gamma=0.424). In female, there was a positive linear relationship between age and CHL thickness (p<0.01, gamma=0.610). However, in male, there was no significant correlation (gamma=0.224). The mean value of CHL thickness was 1.53 mm in 9 adhesive capsulitis and 0.92 mm in 35 asymptomatic ones. CHL thickness was significantly greater in adhesive capsulitis than in asymptomatic ones (p < 001). CONCLUSION: The thickened CHL is a good suggestive diagnostic value of adhesive capsulitis.
Adhesives ; Bursitis ; Elbow ; Female ; Forearm ; Hand ; Humans ; Humerus ; Ligaments ; Male ; Shoulder ; Transducers

OBJECTIVE: To know the clinical and histopathologic profiles of ovarian tumors. METHODS: 822 women undergone operations for their ovarian tumors were enrolled in this study from July of 1996 to June of 2004 at Inha University Hospital in S. Korea. Incidence, age, laterality and size were analyzed according to their histopathologic results. RESULTS: Among 822 women, there were 2.1% of non-neoplastic ovarian cysts, 81.0% of benign tumors, 4.4% of borderline tumors, and 12.5% of malignant tumors. Among benign tumors, 48.2 were cystic teratomas, 22.5% were mucinous, and 19.4% were serous tumors. Among borderline tumors, 52.8% were mucinous and 42.2% were serous. Among malignant tumors, 25.2% were serous and metastatic, respectively, and 18.4% were mucinous. The average and median age of non-neoplastic cysts were 39.1 +/- 12.7, 41 years old, those of benign tumors were 38.2 +/- 18.4, those of borderline tumors were 33.4 +/- 16.7, 28, and those of malignant tumors were 47.8 +/- 15.4, 49. The bilaterality of benign tumors was 10.7%, that of borderline were 16.7%, and that of malignant were 24.2%. The average and median diameter of non-neoplastic cysts were 3.2 +/- 1.4 cm, 3 cm, those of benign tumors were 8.1 +/- 4.3 cm, 7 cm, those of borderline tumors were 13.5 +/- 7.8 cm, 12 cm, and those of malignant tumors were 10.2 +/- 6.1 cm, 9.3 cm. CONCLUSION: We analyzed clinical and histopathologic data of 822 ovarian tumors.
Adult ; Female ; Humans ; Incidence ; Korea ; Mucins ; Ovarian Cysts ; Ovarian Neoplasms ; Teratoma

OBJECTIVE: This study compared the symptomatic emotional traits of elderly South Korean patients with hwa-byung and those with depression. METHODS: We enrolled 58 patients with hwa-byung, 180 patients with depression, and 181 healthy control subjects. All participants completed the Hwa-byung Scale, Hamilton Depression Rating Scale (HDRS), Beck Depression Inventory (BDI), Geriatric Depression Scale (GDS), State Trait Anger Expression Inventory (STAXI), Reaction Inventory (RI), and Aggression Questionnaire (AQ). Chi-square tests and a one-way analysis of variance with Games-Howell post-hoc tests were used to compare demographic variables and scores. RESULTS: A binary logistic regression analysis was used to examine risk factors for hwa-byung. Scores in the hwa-byung group were higher than those in the depression group for the HDRS; BDI; GDS; trait anger STAXI subscale (trait anger temperament and trait anger reaction); state anger and anger expression STAXI subscales (anger-in, anger-out, and anger control); physical and verbal aggression as well as anger and hostility AQ subscales; and disturbance, embarrassing circumstances, personal disrespect, and unpleasant encounters RI subscales. A binary logistic regression analysis demonstrated that the state anger STAXI subscale, verbal aggression and anger AQ subscales, and unpleasant encounters RI subscale were significantly associated with hwa-byung. CONCLUSION: Elderly patients with hwa-byung had more severe anger traits and states as well as higher depression severity compared to those diagnosed with clinical depression. Excessive anger and anger reactivity to unpleasant factors may be risk factors for hwa-byung, whereas the appropriate expression (rather than suppression) of anger may decrease the risk of hwa-byung.
Aged* ; Aggression ; Anger ; Depression* ; Ethnopsychology ; Hostility ; Humans ; Logistic Models ; Risk Factors ; Temperament

Staphylococcus lugdunensis is a member of coagulase-negative staphylococci (CoNS), an uncommon microbial culture isolate with virulent potency. Although CoNS are common skin commensals, and often regarded as contaminants or colonizers when isolated from clinical specimen cultures, the clinical course and microbiological characteristics of Staphylococcus lugdunensis may resemble those of Staphylococcus aureus rather than other CoNS. Invasive infectious diseases such as infective endocarditis, peritonitis, skin and soft tissue infection, vascular prosthetic infection, septicemia, and osteomyelitis have been found to be associated with Staphylococcus lugdunensis. Here we report the first case of psoas abscess caused by methicillin-sensitive Staphylococcus lugdunensis in Korea.
Colon ; Communicable Diseases ; Endocarditis ; Korea ; Osteomyelitis ; Peritonitis ; Psoas Abscess* ; Sepsis ; Skin ; Soft Tissue Infections ; Staphylococcus aureus ; Staphylococcus lugdunensis* ; Staphylococcus*

BACKGROUND: The tibial tuberosity-trochlear groove (TT-TG) distance is used to determine the necessity of tibial tubercle osteotomy. We conducted this study to determine the extent to which each of the tibial tuberosity lateralization, trochlear groove medialization, and knee rotation angle affects the TT-TG distance in both normal and patella dislocated patients and thereby scrutinize the rationale for tuberosity transfer based on the TT-TG distance. METHODS: Retrospective analysis of rotational profile computed tomography was done for patella dislocated and control group patients. Femoral anteversion, tibial torsion, knee rotation angle, tuberosity lateralization, and trochlear groove medialization were assessed in all patients. Relationship of these parameters with the TT-TG distance was investigated to evaluate their effects on the TT-TG distance. RESULTS: We observed that the patellar dislocation group, compared to the control group, had increased TT-TG distance (mean, 19.05 mm vs. 9.02 mm) and greater tuberosity lateralization (mean, 64.1% vs. 60.7%) and tibial external rotation in relation to the femur (mean, 7.9° vs. −0.81°). CONCLUSIONS: Tuberosity lateralization and knee rotation were factors affecting patellar dislocation. These factors should be considered in addition to the TT-TG distance to determine the need for tibial tubercle osteotomy in patients with patellar dislocation.
Femur ; Humans ; Knee ; Osteotomy ; Patella ; Patellar Dislocation* ; Retrospective Studies

PURPOSE: To assess the knowledge and the accuracy of cricoid pressure applied by emergency department (ED) personnel. METHODS: A prospective, observational study was conducted for 100 ED personnel (57 doctors, 38 nurses, and 5 EMTs) who participated in emergency airway training courses. Each participant was asked to complete a knowledge survey and the accuracy of cricoid pressure applied was evaluated using the training manikin. Three attempts were measured and a mean value was calculated. Subgroup analysis was also performed for specific variables of interest. RESULTS: Only thirty-four participants (34%) applied adequate cricoid pressure, with all participants who were outside of the target range applying less than the target amount. No statistically significant difference was demonstrated for age, qualifications, years of experience, existence of prior instruction, accuracy in knowledge, or ability to apply cricoid force within the target range. Male participants applied correct cricoid pressure within the target range more often than females (p=0.035, odds ratio=6.987, CI:1.145-42.641). CONCLUSION: Both knowledge and the application of adequate cricoid pressure by ED personnel were inadequate. In particular, females more often applied low cricoid pressure in order to guard against regurgitation than did males. Repeated hands-on training is recommended using adequate methods that integrate the concept of force.
Cricoid Cartilage ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Male ; Manikins ; Observational Study ; Prospective Studies

The most common form of allergic dermatitis due to orthopedic implant is persistent eczematous reaction. We present an allergic dermatitis occurring in the right upper arm of 77-year-old man who presented an erythematous edematous patch & plaque on the right upper arm after humerus osteosynthesis with orthopedic implant. The lesion disappeared after the removal of the orthopedic implant.
Aged ; Arm ; Dermatitis* ; Humans ; Humerus ; Orthopedics* ; Patch Tests

Gastric cancer is the most common malignancy in Korea. Although five years survival rate of gestric cancer has been gradually improved due to advances in the diagnostic technique and therapeutic modalities, the advanced gastric cancer remains a disease with poor pragnosis. At the time of diagnosis, the disease, is usually advanced and longterm survivor is uncommon without a proper surgical treatment or chemotherapy. We experienced a case of advanced gastric cancer who lived for more than 6 years after making a diagnosis, without curative surgical therapy or chemotherapy. The patient at age of 76 year-old, was seen in St. Mary's hospital due to gastroinestinal bleeding in January of l985. A large ulcerating cancer in the diameter of 2.0 cm was found at the posterior wall of body with endoscopy and confirmed the diagnosis of stomach cancer by the endoscopic biopsy. He was recommended the surgical intervention of gastric cancer but he denied the operation due to his age, He had been treated symptomatically with H2 receptor antagonist and antacid with relief of symptoms. Thereafter he had been followed-up clinically at every 2-4 weeks, and the lesion was examined 3-4 times in a year endoscopically, In May l990, an endoscopic esophageal dilation was done due to esophageal stricture with tumor invasion at the lower esophageal sphincter. He was expired in July, 1991 in this hospital. Here we report a case of long term survived advanced gastric cancer who had been followed-up for 6 and half years clinically and endoscopically with review of literatures.
Aged ; Biopsy ; Diagnosis ; Drug Therapy ; Endoscopy ; Esophageal Sphincter, Lower ; Esophageal Stenosis ; Hemorrhage ; Humans ; Korea ; Stomach Neoplasms* ; Survival Rate ; Survivors ; Ulcer