No abstract available.
Indicators and Reagents*

No abstract available.
Indicators and Reagents*

BACKGROUND: The TrepanostikaTM is an enzyme-linked immunosorbent assay (ELISA) for the qualitative determination of specific antibody (Ab) to Treponema pallidum. It is important to detect Treponema pallidum-specific Ab to confirm syphilis in patients with positive nontreponemal result or at late latent stage/late stage. Currently various ELISA methods for Treponema pallidum- specific Ab have been developed in addition to widely used treponemal tests such as fluorescent treponemal antibody absorption (FTA-ABS) test or Treponema pallidum hemagglutination (TPHA) test. We evaluated TrepanostikaTM, anti-treponemal ELISA test. METHODS: The sensitivity and specificity of this ELISA method for detecting Treponema pallidum- specific Ab (TrepanostikaTM) were evaluated and compared with other treponemal tests such as FTA-ABS and TPHA. RESULTS: The sensitivity and specificity of TrepanostikaTM were 95.7% and 95.8%, respectively. The concordance rate with FTA-ABS was 98.9% (283/286) and 100% (272/272) with TPHA. CONCLUSIONS: TrepanostikaTM which has similar sensitivity and specificity with FTA-ABS or TPHA could replace the well-known treponemal test such as FTA-ABS or TPHA.
Absorption ; Enzyme-Linked Immunosorbent Assay* ; Hemagglutination ; Humans ; Sensitivity and Specificity ; Syphilis ; Treponema pallidum ; Treponema*

Interstitial cell tumor of testis is relatively rare, comprising only 0.8 to 1.4 percent of all testicular tumors. A 67-year-old man was admitted to our hospital with rapid growing testicular mass. He had the experience of hydrocele and many times of aspiration since childhood. On physical examination, the testicular mass (left) was hard, adult fist sized and associated with transparent cystic fluid. Under the impression of testicular tumor, orchiectomy was performed. We report this case with review of literature.
Adult* ; Aged ; Humans ; Leydig Cell Tumor* ; Orchiectomy ; Physical Examination ; Testicular Neoplasms ; Testis*

BACKGROUND: Propofol is a drug which has both sedative and anxiolytic properties which when given in IV form can provide a rapid onset of effects. However inter-individual dose requirement can vary widely, making titiration to effect essential. Patient-controlled sedation (PCA), which administers bolus doses of the sedative agent to the point at which the patient is satisfied have been found to be both effective and popular for patients undergoing surgery under loco-regional anethesia. The aim of this study was to compare the effectiveness and quality of target-controlled infusion (TCI) of propofol by the anesthesiologist (anesthesiologist-controlled sedation: ACS) versus PCS to achieve conscious sedation. METHODS: Sixty patients scheduled to undergo spinal anesthesia with 0.5% hyperbaric bupivacaine 12-18 mg or brachial plexus block with 1% lidocaine 40 ml were divided into 2 groups. In the ACS group (n = 30), the initial target concentration of propofol was 1.0 microgram/ml and the target concentration was adjusted in steps of 0.2 microgram/ml to maintain an Observer's Assesment of Alertness/Sedation (OAA/S) score of 3 with a TCI pump. In the PCS group (n = 30), a 20 mg bolus of propofol was delivered at each button without a lockout interval to the point at which a patient was satisfied with the level of sedation. Infusion rate, total dosage, duration of induction and recovery and recall of operative procedure were checked. BIS, EKG, heart rate, noninvasive anterial blood pressure, respiratory rate and SpO2 were recorded during the operation. RESULTS: The mean (range) infusion rate and total infusion dose were not significantly different with each group: ACS 38.5 (13.1-101.0) microgram/ml, 132 (80-241) mg/h and PCS 25.4 (21.3-80.1) microgram/ml, 118 (69-220) mg/h. Duration of induction was significantly extended in the PCS group (5.8 min) as compared with the ACS group (2.9 min)(P < 0.05). The intensity of amnesia related to blood propofol concentration was more improved in the ACS group and inadequate sedation and involuntary movement were occurred more frequently in the PCS group. CONCLUSIONS: PCS with propofol provided more effective sedation, but had more frequent delayedinduction time, inadequate sedation and incomplete amnesia than ACS.
Amnesia ; Anesthesia, Conduction* ; Anesthesia, Spinal ; Blood Pressure ; Brachial Plexus ; Bupivacaine ; Conscious Sedation ; Dyskinesias ; Electrocardiography ; Equidae ; Heart Rate ; Humans ; Lidocaine ; Propofol* ; Respiratory Rate ; Surgical Procedures, Operative

No abstract available.
Adenocarcinoma* ; Female* ; Humans ; Urethra*

BACKGROUND: The quantification of hepatitis C virus (HCV) is useful in diagnosis and monitoring of HCV infection. We evaluated clinical usefulness of HCV quantification and two quantification methods using different assay principles. METHODS: HCV RNA quantities and liver function were measured in patients with different disease severity using bDNA assay (QuantiplexTM, Chiron, USA). HCV RNA loads were quantified at the time of pre/post-interferon treatment in some of them using RT-PCR hybridization assay (AMPLICORTM, Roche, USA). These two quantification methods were also compared. RESULTS: HCV RNA loads showed no significant difference according to disease severity (group I, 3.8 5.3 MEq/mL; group II, 3.8 7.4 MEq/mL; group III, 5.9 13.0 MEq/mL; P=0.181) or interferon response (complete responders, 1.5 105/mL; partial or non responders, 2.2 105/mL; P=0.670). But HCV viral loads decreased at 6th month after interferon treatment (P=0.063) and correlated poorly with liver function tests. The bDNA assay correlated well with the RT-PCR hybridization method (r2=0.854). CONCLUSIONS: The quantificaion of HCV RNA is useful in following up treatment effect but not in predicting therapeutic failure or assessment of disease severity. HCV RNA quantities are independent of liver function. The bDNA assay showed good correlation with the RT-PCR hybridization method.
Branched DNA Signal Amplification Assay ; Diagnosis ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Interferons ; Liver Diseases* ; Liver Function Tests ; Liver* ; RNA ; Viral Load

BACKGROUND: Cryptococcus neoformans is an increasingly important pathogen in the immunosuppressed hosts. The aim of this study was to determine any change of the clinical features and to evaluate the laboratory diagnosis in cryptococcosis patients. METHODS: The clinical features of cryptococcsis patients who were diagnosed in Severance Hospital during the 1983~1995 were reviewed retrospectively and various diagnostic laboratory tests, especially latex cryptococcal antigen test were evaluated. RESULTS: The number of crytococcosis patients increased over the years. Twenty-six patients had various underlying diseases including two AIDS patients. Of the 43 patients, 41(95%) had CNS infections, while the patients with non-CNS infections were 10(23%). Latex antigen test, culture, India ink preparation, and Gram stain were positive in 100%, 87 %, 60% and 51%, respectively. Positivity of latex antigen test, India ink preparation, and culture persisted in average 69 days, 26 days, and 12 days, respectively in recovered patients. CONCLUSION: The number of cryptococcosis patients is an increasing trend in the Severance Hospital probably due to the increase of immunocompromised patients, and latex antigen test is a highly sensitive and reliable screening test for the laboratory diagnosis.
Clinical Laboratory Techniques ; Cryptococcosis* ; Cryptococcus neoformans ; Diagnostic Tests, Routine* ; Humans ; Immunocompromised Host ; India ; Ink ; Latex ; Mass Screening ; Meningitis ; Retrospective Studies

BACKGROUND: In patients with systemic lupus erythematosus (SLE), serum factors play a role in the apoptosis and necrosis of neutrophils. We intended to verify that autoantibodies including anti-dsDNA antibody are one of the factors. We also investigated the potential usefulness of simultaneous flow cytometric measurement of cytotoxicity and autoantibody binding to neutrophils in SLE sera for evaluation of disease activity. METHODS: A total of 228 sera from 48 patients with lupus nephritis (LN), 19 patients with SLE without LN, 35 patients with rheumatoid arthritis (RA) and 40 healthy males were studied. Whole blood from healthy males mixed with test sera was incubated. Autoantibody binding, apoptosis and necrosis of neutrophils were measured by flow cytometry using IgG-FITC and 7-aminoactinomycin D after a 20-hour incubation period or after adjustments of incubation conditions. The results were expressed as the test/healthy control ratio of measured values, and the correlations between these results and anti-dsDNA antibody levels were investigated. RESULTS: IgG mean fluorescence intensity (MFI) ratio was 1.0+/-0.3, 1.6+/-1.6, 2.0+/-1.5 and 4.8+/-7.5 in the healthy, RA, SLE and LN group, respectively, and showed a significant increase in the LN group when compared with the healthy group (N=20 in each group, P<0.05). Apoptosis & necrosis ratio was 1.0+/-0.2, 1.0+/-0.5, 1.6+/-1.0 and 2.6+/-1.9 in each of the above 4 groups, and showed a significant increase in the LN group when compared with the healthy (P<0.005) and RA group (P< 0.01). By immunofluorescence microscopy, increased nuclear reactivities on neutrophils by autoantibody binding were observed in 12 (60%) of 20 LN sera. All three correlations between anti-dsDNA antibody level, apoptosis & necrosis ratio and IgG MFI ratio were significant (P<0.0005). Preincubation with DNA extracts decreased both IgG MFI ratio and apoptosis & necrosis ratio significantly (N=25, P<0.05). CONCLUSIONS: Our findings confirm the previous reports of increased neutrophil apoptosis in the peripheral blood of patients with SLE. This study indicates that anti-dsDNA antibody or other antinuclear antibodies in sera are associated with an active increase in the apoptosis and necrosis of neutrophils as well as simple binding to neutrophils. This may suggest that autoantibodies increase the exposure of autoantigen DNA and exacerbate autoimmunity in the pathogenesis. Although further studies are needed, we suggest that measuring the cytotoxicity and autoantibody binding to neutrophils in SLE serum simultaneously by flow cytometry should be a useful test for evaluation of disease activity.
Antibodies, Antinuclear ; Apoptosis* ; Arthritis, Rheumatoid ; Autoantibodies ; Autoimmunity ; DNA ; Flow Cytometry ; Fluorescence ; Humans ; Immunoglobulin G ; Lupus Erythematosus, Systemic* ; Lupus Nephritis ; Male ; Microscopy, Fluorescence ; Necrosis ; Neutrophils*

BACKGROUND: Recently in Korea, the rate of addictive drug abuse is rapidly increasing in men on salary, housewives, and even in adolescents, who have been considered to be free from drugs, which presents a serious problem to the society. Especially, the habituation to gateway drug, such as cigarettes and alcohol, before 15 years old, would lead to the increased possibility of other drug abuse, including illicit drugs. Thereupon in this study, we intended toreview the effect of adolescents smoking an the drug abuse and deviated behaviors. METHODS: On September, 1997, randomly selected were 12 classes, an the basis of 2 classes per grade, from the two schools which was located each in Seoul and Buchean. And survey was dane on 610 students with non non-nominl, self-reported questionnaire. RESULTS: The rate of adolescent smoking was 28.1% in male students and had increasing tendency of "the higher the grades, the higher the smoking rate"(17.0% in the 1st gade, 31.5% in the 2nd grade, 35.9% in the 3rd grade). The smoking rate of female students was 12.3%. From the 2nd grade of middle school to the 2nd grade of high school was the critical period when the smoking habit was initiated in almost 90% of the students. The experiencing rates of drug abuse in studied subjects were as follows : drinking(79.0%), stimulants(4.8%), sedatives(4.1%), hypnotics(3.1%), glue sniffing(1.5%), butane gas(0.7%), marijuana/hemp(0.2%). They were higher in the smoking group than in the nansMoking group, showing statistical significances in most items except hypnotics and marijuana/hemp. Also simihr results were shown in deviated behaviors between the groups. CONCLUSIONS: With the concerted efforts of family, school, society and natian, we as family physicians should make efforts to delay and prevent adolescent's smoking, which is a gateway to drug abuse and deviated behaviors, and to increase people's recognition of health risks caused by smoking, and to provide proper program for adolescents to stop smoking.
Adhesives ; Adolescent ; Critical Period (Psychology) ; Female ; Humans ; Hypnotics and Sedatives ; Korea ; Male ; Physicians, Family ; Salaries and Fringe Benefits ; Seoul ; Smoke* ; Smoking* ; Street Drugs ; Substance-Related Disorders* ; Tobacco Products ; Surveys and Questionnaires