BACKGROUND: There is increasing concern in many countries about the problem of drug-resistant tuberculosis. Prevalence of primary drug-resistant tuberculosis is the optimal epidemiological indicator for long term monitoring of national tuberculosis control program. Our purpose was The purpose of our study is to assess clinical characteristics and socioeconomic status of patients with drug-resistant tuberculosis. METHODS: We studied 68 cases with durg-resistant Mycobacterium tuberculosis infection diagnosed at the Ewha Womans University Mokdong Hospital from March, 1995 to February, 2000. RESULTS: Patients with primary drug-resistant tuberculosis(PDR) were younger(39.6±16.3 years vs. 48.2±16.5 years; p<0.05), had more population of less than more were under the age of 40 years aged-group(62.9% vs. 36.4%; p<0.05) and were more highly educated than those with acquired drug-resistant tuberculosis(ADR)(38.9% vs. 11.1%; p<0.05). In patients with ADR, the rates of familial history of tuberculosis and living in a rented house residence in a rented house were increased higher than compared with to those of patients with PDR. Patients with ADR had more involved lobes(2.0±0.8 vs. 1.4±0.7; p<0.01) and longer treatment duration than those with PDR(18.3±7.2 months vs. 10.6±6.3 months; p<0.05). Patients with ADR showed larger numbers of resistant were resistant to more number of drugs, lower hospitalization rate and higher rate of self-interruption of medication than those with PDR. In patients with PDR, mono-drug resistance was increased, whereas poly-and multi-drug resistances were decreased compared with those with ADR. Resistance to isoniazid was the highest among antituberculosis drugs, and resistance to isoniazid in patients with ADR was higher than that in patients with PDR(90.9% vs. 71.4%; p<0.05). CONCLUSIONS: Patients with ADR were more likely to include more population be of lower socioeconomic class, and patients with PDR seem seemed to be young and socially active population. For control of drug-resistant Mycobacterium tuberculosis infection, proper isolation and prevention of patient with drug-resistant tuberculosis are needed.
Female ; Hospitalization ; Humans ; Isoniazid ; Mycobacterium tuberculosis ; Prevalence ; Social Class ; Tuberculosis ; Tuberculosis, Multidrug-Resistant*

The goal of total knee replacement is to relieve pain, to stabilize joint movement and to correct deformity. It is indicated for patients with rheumatoid arthritis, osteoarthritis and severe post-traumatic arthritis. The author analyzed 71 patients(106 cases), who received the PFC type of total knee replacement from August 1992 and the results were as follows; 1. Among the 71 patients, male was 8 patients and female was 63 patients whose average age was 56 years and average follow up period was 24 months, ranged from 8 months to 3 years 8 months. 2. Rheumatoid arthritis was the most common cause with 31 patients(56 cases) followed by osteoarthritis with 39 patients(49 cases). There was also one patient(1 case) that showed bony union of the knee due to old tuberculosis. The average duration of the illness was 12 years and the average weight of the patients was 57.7kg. 3. Flexion contracture decreased from an average of 21 degrees to 5 degrees after the operation. The range of motion increased from an average of 92 degrees before the operation to 117 degrees afterwards in cases of rheumatoid arthritis and decreased slightly from 108 degrees to 106 degrees in cases of osteoarthritis. 4. The tibiofemoral angle was corrected from an average 1.5 degrees varus before the operation to an average 6.7 degrees valgus after operation. Eighty seven percent of patients with rheumatoid arthritis showed valgus deformity and seventy eight percent of degenerative osteoarthritis patients showed varus deformity preoperatively. 5. Radiographically, the joint line position shifted an average 2.3mm in rheumatoid arthritis and an average 0.3mm in osteoarthritis. The component position, the femoral flexion was an average 89.6 degrees in the anteroposterior view, an average 87 degrees in the lateral view. 6. The thickness of the patella measured in the operating room of 61 cases was an average 21mm and after resection of patella, the remaining bone measured an average of 13.6mm. 7. To achieve soft tissue balance, 29 patients(33 cases) underwent medial stripping and 23 patients(30 cases) had patella lateral release. 8. The Insall Knee Rating Score was used to evaluate the results. The results were 69 cases excellent, 33 cases good, 3 fair and 1 poor. Ninety two percent of the patients had good or excellent results in average 24 months follow-up. 9. The complications consisted of one case of delayed deep infection, one case of patellar subluxation and one case of supracondylar fracture of the femur.
Arthritis ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Knee ; Congenital Abnormalities ; Contracture ; Female ; Femur ; Follow-Up Studies ; Humans ; Joints ; Knee ; Male ; Operating Rooms ; Osteoarthritis ; Patella ; Range of Motion, Articular ; Tuberculosis

No abstract available.
Cholelithiasis* ; Diverticulum*

Despite significant advances in the diagnosis and treatment of various malignancies, the management of esophageal cancer remains one of the least responsive malignancies, Unfortunately complete excision of the tumor is impossible, because expandable anatomic structures are involved early when the diagnosis is made. (continue...)
Diagnosis ; Esophageal Neoplasms* ; Esophagus

The usefulness of microscopic examination of pure bile directly collected from the biliary tract during endoscopic retrograde cholangiography and without hormonal stimulation was evaluated in 86 patients. Cholesterol monohydrate crystal and/or calcium bilirubinate granule were observed in the bile of 64% of GB stones, 88% of CBD stones and l00% of IHD stones. But only 4% of non stone control group were positive crystals examinations. According to this results, microscopic examinations:of bile samples collected during endoscopic retrograde cholangiography exhibited a sensitivity and a specificity for cholelithiasis recognition of 82.3% and 95.8%, respectively, with a positive and negative predictive value of 98.1% and 67.6%, respectively. We conclude that microscopic bile examinations of bile samples collected during ERC is useful to investigate in patients with suspected cholelithiasis.
Bile* ; Biliary Tract ; Bilirubin ; Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Cholelithiasis ; Cholesterol ; Gallstones ; Humans ; Sensitivity and Specificity

To investigate the diagnostic accuracy of ERCP in pancreatobiliary disease, the authors analysed the 1,244 cases of ERCP. The success rate of ERCP was 91.5%. The diagnostic accuracy of ERCP was 93.6% and complications occurred in 2.1%. Complications included pancreatitis,cholangitis and drug reactions. Among the biliary tract disease diagnosed, by ERCP, biliary tract stone was the most common finding. Compared with operative diagnosis of biliary tract stones,the sensitivity of ERCP diagnosis was 92.7% while that of sonographic diagnosis was 81.4%. The specificity of ERCP diagnosis was 94.4% while that of sonagraphic diagnosis was 80.9%. ln the diagnosis of common bile duct stones, ERCP was more accurrate than sonographic diagnosis. The results show that ERCP was a safe and effective diagnostic tool in the assessment of pancreatobiliary tract disease.
Biliary Tract ; Biliary Tract Diseases ; Cholangiopancreatography, Endoscopic Retrograde* ; Common Bile Duct ; Diagnosis ; Sensitivity and Specificity ; Ultrasonography

To investigate the diagnostic accuracy of ERCP in pancreatobiliary disease, the authors analysed the 1,244 cases of ERCP. The success rate of ERCP was 91.5%. The diagnostic accuracy of ERCP was 93.6% and complications occurred in 2.1%. Complications included pancreatitis,cholangitis and drug reactions. Among the biliary tract disease diagnosed, by ERCP, biliary tract stone was the most common finding. Compared with operative diagnosis of biliary tract stones,the sensitivity of ERCP diagnosis was 92.7% while that of sonographic diagnosis was 81.4%. The specificity of ERCP diagnosis was 94.4% while that of sonagraphic diagnosis was 80.9%. ln the diagnosis of common bile duct stones, ERCP was more accurrate than sonographic diagnosis. The results show that ERCP was a safe and effective diagnostic tool in the assessment of pancreatobiliary tract disease.
Biliary Tract ; Biliary Tract Diseases ; Cholangiopancreatography, Endoscopic Retrograde* ; Common Bile Duct ; Diagnosis ; Sensitivity and Specificity ; Ultrasonography

No abstract available.
Extracellular Space* ; Ischemia* ; Myocytes, Cardiac*

The study was undertaken to assess the ventricular system of the brain in normal korean adults on the base ofCT. The computerized tomographic examinations of 334 Korean adults between ages of 15 to 50 years, performed atSeoul National University Hospital, were evaluated. The known to be a reliable indicator of the ventricular size.This ratio was measured at the level of the lateral, third and fourth ventricles respelctively. The shape of thequardigeminal and suprasellar cistern was analyzed. The resuls are as follows; 1. The cerebroventricular ratios ofthe lateral ventricle at the level of the widest bifrontal and bicaudate diameters were 0.30±0.04 and 0.14±0.02,respectively. The lateral ventricle was asymmetric in 12.6%, of which the left side was usually larger than theright. 2.There was correlation between the cerebroventricular ratio and age, i,e., with increase of age, the C-Vratio increased slightly. 3. The cerebroventricular ratio of the third ventricle was 0.03±0.01. 4. Thecerebroventricular ratio of the fourth ventricle in width and height was 0.14±0.02 and 0.10±0.03, respectively.The anteroposterior position index of the fourth ventricle was 0.42±0.04. 5. The quadrigeminal cistern showedU-shape in 23.4%. 6. The suprasellar cistern showed pentagonal shape in 61.1%, round in 28.4% and hexagonal in10.5%. 7. There was no significant difference between male and female according to the above results.
Adult ; Brain ; Female ; Fourth Ventricle ; Humans ; Lateral Ventricles ; Male ; Third Ventricle

Certain motion in the sports of volleyball can cause injury. For examples, excessive spiking, jumping, receiving and rolling may produce strain, sprain and stress fracture, etc. of all extremities and spine. The authors analized injuries of 160 Korean young women volleyball players treated and managed at Department of Orthopedic Surgery, National Police Hospital from September, 1973 to October, 1977. The results were as followings: 1. Of 160 cases, age distribution was ranged from 15 to 26 years and average was 20. 7 years. 2. Out of 495 injuries, 113 (23%) were upper extremities, 93 (19%) were lumbar and lumbosacral regions and 289(58%) were lower extremities. The most common site of injury was knee joint. 3. As to the ratio of the side, in the upper extremities 77% were in the right side and 23% in the left, but in the lower extremities both sides were nearly equal. 4. The injuries were composed of strain, sprain and the others, including stress fracture in 14, linear fracture of patella in 2, chip fracture of ulnar styloid process in 4, H.I.V.D. in 4 and meniscus tear in 6, etc.. 5. The injuries were supposed to be prevalent for the first one month after change from one to another team (14%). 6. The injury was usually more frequent in incidence among the exercise in winter and the heating in Gymnasium also one of the important factors to induce the injury, the injuries were less frequent at the good heating (40%). 7. It was concluded that the career of play did not affect significantly to incidence of the injury.
Age Distribution ; Athletic Injuries ; Extremities ; Female ; Fractures, Stress ; Heating ; Hot Temperature ; Humans ; Incidence ; Knee Joint ; Lower Extremity ; Lumbosacral Region ; Orthopedics ; Patella ; Police ; Spine ; Sports ; Sprains and Strains ; Tears ; Upper Extremity ; Volleyball