We describe a riboprinting scheme for identification of unknown Acanthamoeba isolates at the species level. It involves use of the PCR-RFLP of small subunit ribosomal RNA gene (riboprint) of 24 reference strains by 4 kinds of restriction enzymes. Seven strains in morphological group I and III were identified at species level with their unique sizes of PCR product and riboprint type by Rsa I. Unique restriction fragment length patterns of 17 strains in group II by Dde I, Taq I and Hae III were classified into: (1) four taxa that were identifiable to the species level, (2) a subgroup of 4 taxa and a pair of 2 taxa that were identical to each other, and (3) a species complex of 7 taxa assigned to A. castellanii complex that were closely related. These results were consistent with that of 18s rDNA sequence analysis. This approach provides an alternative to the rDNA sequencing for rapid identification of a new clinical isolate or large number of environmental isolates of Acanthamoeba.
Acanthamoeba/classification/genetics/*isolation & purification ; Animals ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; RNA, Protozoan ; RNA, Ribosomal ; Ribotyping/*methods

1. 39 cases of fractures of the distal femur treated at the Gwang Ju Triservice Armed Hospital during period from January, 1968 to May, 1973 were subjected to analysis. 2. Most common cause of fracture was traffic accident and supracondylar fractures were most common. 3. Of 39 cases, 22 cases were treated by closed method with or without skeletal traction and 17 cases were treated by open reduction and internal fixation. 4. Closed methods resulted in better funtional recovery after union of fracture. 5. The healing period was 14 weeks in average.
Accidents, Traffic ; Adult ; Arm ; Clinical Study ; Femur ; Gwangju ; Humans ; Methods ; Traction

A retrospective quality assurance study of intraoperative consultation (frozen section) was carried out to assess the accuracy and to determine the reasons of discordance. Of 14,977 surgical pathology cases accessioned over a 6-month period in Asan Medical Center, frozen sections were done on 1,270 (8.5%) patients and 2,392 frozen sections (1.88 frozen sections/case) were performed. Discordance was noted in 106 cases (4.4%) and diagnosis was deferred in 26 cases (1.1%). All deferred cases were reviewed with the result of 53.8% justified and 46.2% unjustified. The discordant cases were divided into three categories as to their clinical significances: category A (no affect on patient care) 61.3%, B (minimal affect) 9.4%, and C (major affect) 29.2%. Of 31 category C cases, 7 cases were false positive and 24 cases were false negative. Misinterpretation (70.8%) was the leading cause of discordance, followed by sampling error (15.1%), failure to identify lesion (8.5%), and technical problem (5.7%). More than one-third (35.8%) of all discordances were of central nervous system cases. Total central nervous system cases were 403 (16.8%) with a significantly higher disordance rate (9.8%) and deferral rate (2.5%) in comparison to the other cases with 3.4% discordance rate and 0.8% deferral rate. There were 43 colorectal cancer cases of intraoperative consultation for adequacy of resectional margins. The surgical margins were between 0.4 cm and 28 cm (mean: 6.7 cm) away from the tumor and there was no tumor-positive case. The study indicates surgical pathology should 1) promote interpretative skills in cases involving minute fragments of neurosurgical cases, 2) defer the diagnosis and ask for more tissue on inadequate or inappropriate specimens and 3) give only gross opinions without unnecessary frozen section procedures in the event of simple, clear-cut cases.
Abscess ; Anti-Bacterial Agents ; Biopsy ; Central Nervous System ; Chungcheongnam-do ; Colitis, Ulcerative ; Colorectal Neoplasms ; Diagnosis ; Diagnosis, Differential ; Endoscopy ; Enterocolitis, Pseudomembranous* ; Frozen Sections* ; Humans ; Mucous Membrane ; Necrosis ; Pathology ; Pathology, Surgical ; Retrospective Studies ; Selection Bias

The cyclophilins (Cyps) are family members of proteins that exhibit peptidylprolyl cis-trans isomerase (PPIase, EC 5.2.1.8) activity and bind the immunosuppressive agent cyclosprin A (CsA) in varying degrees. During the process of random sequencing of a cDNA library made from Giardia intestinalis WB strain, the cyclophilin gene (gicyp 1) was isolated. An open reading frame of gicyp 1 gene was 576 nucleotides, which corresponded to a translation product of 176 amino acids (Gicyp 1). The identity with other Cyps was about 58-71%. The 13 residues that constituted the CsA binding site of human cyclophilin were also detected in the amino acid sequence of Gicyp 1, including tryptophan residue essential for the drug binding. The single copy of the gicyp 1 gene was detected in the G. intestinalis chromosome by southern hybridization analysis. Recombinant Gicyp 1 protein clearly accelerated the rate of cis-- Amino Acid Sequence ; Animals ; Cloning, Molecular ; Cyclophilins/antagonists & inhibitors/chemistry/genetics/*isolation&purification ; Cyclosporine/metabolism/pharmacology ; Giardia lamblia/*chemistry/genetics ; Human ; Immunosuppressive Agents ; Molecular Sequence Data ; Protein Binding ; Protozoan Proteins ; Recombinant Proteins

The cell cycle is composed of G1, S, G2 and M phase. The transitions between different phases are regulated at checkpoint such as Start(restriction), S phase and mitotic checkpoint. These checkpoints are regulated by specific cyclins and Cdks(cyclin-dependent kinases). Especially, Start checkpoint in late G1 is though to be very important in control of cell cycle. In this study, it was shown various CDKN2(p16ink4A) alteration, including deletions, mutations, down regulations, and performed differential expression of p53, Cdk4, PCNA and pRb in stomach cancer tissues. 1. The frequency of CDKN2 mutations was not observed in the 19 primary stomach cancer tissues. In contrast to the mutations of CDKN2, mRNA levels was showed by Northern blot analysis that expression of CDKN2 was absent or decreased in 10 of the 19(53%) primary stomach adenocarcinoma. Western blot analysis was performed to determine the differential expression of p53, Cdk4, PCNA related to Start checkpoint. Overexpression of p53 was shown 38%, Cdk4 was expressed in all each specimens, and expression of PCNA was not shown. 2. As the other method to determine the differential expression of p53, Cdk4, PCNA and pRb, immunohistochemical analyses were performed on each 14 formalin-fixed and paraffin embedded tumor tissues of stomach adenocarcinoma. p53 overexpression was showed to clear nuclear staining only in tumor cells not in nonneoplastic cells. In staining for cdk4, the tumor was considered to be cdk4 positive if there was nuclear staining in tumor cells, regardless of cytoplasmic staining. PCNA staining for carcinoma tissues showed more intense nuclear staining in tumor cells than in nonneoplastic cells. pRb overexpression was show in tumor cells. Significant differences were observed in the expression of the proteins among the cancers from different anatomic site. Overexpression of adenocarcinomas had high rate of p53(57.1%) and pRb(71.4% ), and low late of cdk4(7.1% ) and PCNA(14.3% ), As these results, deletion of CDKN2 gene in human stomach cancer was not observed but mRNA expression was down regulated in restriction checkpoint, G1 phase. Inactivation of the CDKN2 gene due to hypermethylation may play an important role in development of cancer. And one of the abnormalities in p53, Cdk4, PCNA or pRb function occurs very common in various cancers, especially oral adenocarcinoma, osteosarcoma and squemous cell carcinoma, suggest that components in restriction checkpoint also play an critical role in the carcinogenesis and progression of cancers.
Adenocarcinoma ; Blotting, Northern ; Blotting, Western ; Carcinogenesis* ; Cell Cycle ; Cell Division ; Cyclins ; Cytoplasm ; G1 Phase Cell Cycle Checkpoints ; Genes, p16 ; Humans ; M Phase Cell Cycle Checkpoints ; Osteosarcoma ; Paraffin ; Proliferating Cell Nuclear Antigen ; RNA, Messenger ; S Phase ; Social Control, Formal ; Stomach ; Stomach Neoplasms

PURPOSE: The purposes of this study were to analyze the MR findings of medulloblastoma, and to evaluate the subarachnoid dissemination and the significance of contrast enhanced MR of brain and spine for tumor.. MATERIALS AND METHODS: The preoperative brain MR studies of 18 patients (9 males, 9 females;mean age, 9.4 years) with surgically proved medulloblastomas were retrospectively reviewed to characterize these neoplasms with regard to their location, size, MR signal intensity, appearance after contrast enhancement, presence of cyst and necrosis, subarachnoid dissemination, and other associated findings. In 14 patients postoperative spine MR studies were evaluated for staging and therapeutic planning. RESULTS: The most frequent location of medulloblastoma was the inferior vermis and the mean tumor size was 4.1 x 3.6 x 3.9 cm. On Tl-weighted image, medulloblastomas generally had low to intermediate signal, predominantly hypointense relative to white matter. On T2-weighted image, medulloblastomas showed modetately high signal, hyperintense relative to white matter. Inhomogeneous contrast enhancement was demonstrated in 13 patients(72.2%) after injection of gadopentetate dimeglumine(Gadolinium). Cyst and necrosis within the tumor were visualized in 15 patients(83.3%). Subarachnoid disseminations of medulloblastomas were noted in 11 patients(61.1%), of which 6 demonstrated intracranial and 2 intraspinal dissemination. Three had both intracranial and intraspinal dissemination. In nine cases with intracranial lesions, there were intraparenchymal mass formation(7), subarachnoid nodules(5), infundibular lesions(2) and diffuse gyral enhancement(I). In five cases with intraspinal lesions, there were extramedullary intradural small nodules(3), central canal nodules(2), intradural masses(I)and fine nodular and sheet-like leptomeningeal enhancement(1). Other associated findings included intratumoral hemorrhage(11.1%), per/tumoral edema(44.4%), tonsillar herniation(44.4%), hydrocephalus(88.9%) and calcification(44.4%). CONCLUSION: Medulloblastomas revealed low to intermediate signal intensity on Tl-weighted image and intermediate to moderately high signal intensity on T2-weighted image, relative to cerebellar white matter. Medulloblastomas were solid tumors with cystic necrosis, which showed inhomogeneous enhancement and subarachnoid disseminations to the intracranial and intraspinal spaces after Gd-DTPA enhancement. Gd-enhanced MR of brain and spine was an useful diagnostic modality in preoperative diagnosis and in staging of postoperative cases of medulloblastomas, which was superior to postcontrast CT or precontrast MR.
Brain* ; Diagnosis ; Gadolinium DTPA ; Humans ; Male ; Medulloblastoma ; Necrosis ; Retrospective Studies ; Spine*

Primary varicella infection usuelly runs a benign clinical course in the helthy population. However, hemorrhagic chicken pox presents with a very extensive eruption of hemorrhagic vesicles in patients with decreaed platelets or impaired immunity and is accompanied by severe constitutional symptoms. A 7-year-old male was admi due to abdompal pain for 1 day and peneralized vesicular eruption for 5 days. The eruption first appeared on the trunk and then spread to involved face, scalp and extrsmities. The skin rash was compatable with varicella but despite the administration of acclovir intravenously, the vesicular eruption became hemorrhagic. Ten days after admission, having experienced cardisc arrest twice and with his mental state in coms, he was diseharged as his situation was hopelesa. We have experienced a giatient diagnosed as having hemorrhagie, chicken pox complicated by encephalopathy.
Chickenpox* ; Chickens* ; Child ; Exanthema ; Humans ; Male ; Scalp

OBJECTIVE: To compare the clinical outcomes of intrauterine insemination (IUI) according to the catheter used. MATERIALS AND METHOD: From March 1998 to September 1998, total 95 infertile patients were included in this study. Patients were randomly allocated to TomCat group (n = 39) and Mackler group (n = 56) according to the catheter for insemination. The controlled ovarian hyperstimulation (COH) using luteal long protocol of gonadotropin releasing hormone agonist (GnRH-a) was used in all patients. Statistical analysis was performed using Student's t-test, Fisher's exact test, and x2 test as appropriate. Statistical significance was defined as p < 0.05. RESULTS: The total dose and duration of exogeneous gonadotropin required were similar between the two groups. There were also no significant differences in serum estradiol (E2) level, endometrial thickness and texture on the day of hCG administration between the two groups. However, the percentage of uterine souding due to failure of initial approach was significantly higher in TomCat group compared to Mackler group (23.1% vs. 0%, p < 0.01). The percentage of bleeding after IUI in TomCat group seemed to be higher than that in Mackler group (15.4% vs. 3.6%, p = 0.06), although there was no statistically significant difference between the two groups. There was also no significant difference in the clinical pregnancy rate per patient between the two groups. CONCLUSION: These results suggested that using Mackler catheter might be effective for IUI, especially for the patients with cervical factor infertility.
Catheters* ; Estradiol ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Hemorrhage ; Humans ; Infertility ; Insemination* ; Pregnancy Rate

This study was conducted to investigate changes of airway size, tongue and hyoid position following orthognathic surgery in mandibular prognathism, and how they are adapted to new environment in tine dependent manner. 37 patients, who had recieved orthognathic surgery, were selected for this study. lateral cephalogram of each patient was taken at preoperation, immediate postoperation, and over 6 month after operation, and were traced and analyzed. The findings of this study were as follows: 1. The size of airway was not changed at PNS and Epiglottis level after operation, but it was changed slightly at 2nd cervical vertebra level. 2. The hyoid was moved inferoposteriorly at immediate postoperation, and then it shifted toward preoperative position, but it remained slightly inferoposterior position. The distance from hyoid to genial tubercle decreased continuously. 3. The position of tongue was moved inferoposteriorly at immediate postoperation, and then it shifted toward preoperation position, but the root of the tongue remained inferoposteriorly. 4. The distance between tongue and hyoid was increased at immediate postoperation and slightly decreased during follow-up period. 5. The change of the mandibular position was not significantly correlated with changes of airway size, hyoid position, tongue morphology and tongue position.
Epiglottis ; Follow-Up Studies ; Humans ; Orthognathic Surgery* ; Prognathism ; Spine ; Tongue*

PURPOSE: To analyze the radiologic findings of facial nerve schwannoma. MATERIALS AND METHODS: The authors retrospectively reviewed CT and/or MR images and clinical history of eight patients with histologically provenfacial nerve schwannoma. After classifying this extratemporal and intratemporal types, clinical and radiologic findings were analysed. RESULTS: The most common clinical findings of facial nerve schwannoma were facial nervepalsy and hearing impairment in an intratemporal schwannoma(4/5), and a palpable parotid mass in an extratemporal schwannoma(3/3). On CT, each involved segment of intratemporal schwannomas(five cases) showed characteristic radiologic findings, while extratemporal schwannomas(three cases) showed masses of various types. On MRI, all tumors(two cases) showed hypointensity on T1WI, hyperintensity on T2WI, and strong enhancement on Gd-DTPA enhanced T1WI. CONCLUSION: Intratemporal facial nerve schwannomas can be easily diagnosed by characteristic clinical and radiologic findings. Extratemporal facial nerve schwannomas show nonspecific findings. However, if the tumor islocated between the superficial and the deep lobe of the parotid gland and extends to the posterior portion of thestyloid process, then facial nerve schwannoma is strongly suspected.
Facial Nerve* ; Gadolinium DTPA ; Hearing Loss ; Humans ; Magnetic Resonance Imaging ; Neurilemmoma* ; Parotid Gland