We compared the performance of three screening kits for the detection of anti-HIV in 187 samples; Enzygnost Anti-HIV 1/2 Plus, ABBOTT TESTPACK HIV- 1/HIV-2 & SERODIA. HIV- 1/2. Four samples, 3 serums and 1 CSF, from 2 patients were repeatedly reactive in all three screening kits and 2 serum specimens were confirmed positive(HIV-1) by the western blot assay. The sensitivity and specificity of all three screening kits were 100% and 98.9%, respectively. In Korea, the cause of AIDS is mostly HIV-1 and the prevalence is very low. So, all three screening kits were useful for the detection of anti-HIV from patients and blood donors. But the use of screening kit for the detection of anti-HIV-1, anti-HIV-2 and anti-HIV-I subtype O will be needed for the decrement of false negative rate because HIV infection has been increased, especially, HIV-2 infection and pediatric AIDS patient by vertical transmission were also reported, currently.
Antibodies* ; Blood Donors ; Blotting, Western ; HIV Infections ; HIV* ; HIV-1 ; HIV-2 ; Humans ; Korea ; Mass Screening* ; Prevalence ; Sensitivity and Specificity

OBJECTIVE: To examine the synergistic effects of both computer-assisted cognitive rehabilitation (CACR) and transcranial direct current stimulation (tDCS) on cognitive function in patients with stroke. METHODS: The current double-blind, sham-controlled study enrolled a total of 11 patients who were newly diagnosed with stroke. The patients of the tDCS group (n=6) completed sessions of the Korean computer-assisted cognitive rehabilitation program five times a week for 30 minutes a session during a mean period of 18.5 days concomitantly with the anodal tDCS over the bilateral prefrontal cortex combined with the CACR. The patients of the control group (n=5) also completed sessions of the sham stimulation during a mean period of 17.8 days. Anodal tDCS over bilateral prefrontal cortex (F3 and F4 in 10-20 EEG system) was delivered for 30 minutes at an intensity of 2 mA. Cathode electrodes were applied to the non-dominant arm. All the patients were evaluated using the Seoul Computerized Neuropsychological Test (SCNT) and the Korean Mini-Mental State Examination. RESULTS: Mann-Whitney U test revealed a significant difference between the two groups. The patients of the tDCS group achieved a significant improvement in the post/pre ratio of auditory continuous performance test and visual continuous performance test on the SCNT items. CONCLUSION: Our results indicate that the concomitant use of the tDCS with CACR to the prefrontal cortex may provide additional beneficial effects in improving the cognitive dysfunction for patients with stroke.
Arm ; Electrodes ; Electroencephalography ; Humans ; Neuropsychological Tests ; Pilot Projects* ; Prefrontal Cortex* ; Rehabilitation* ; Seoul ; Stroke*

For more than 80% of body weight is transmitted through the anterior and middle column, the interbody gap produced by operative reduction of spondylolisthesis is potential risk factor for redisplacement, implant failure, pseudoarthrosis and kyphosis. In biomechanical aspect, augmentation of the anterior column support by interbody fusion is desirable to prevent above problems in surgical treatment of spondylolisthesis. Recently, circumferential fusion is recommended in high-grade spondylolisthesis (grade III, IV, or V ), but there is some controversy about additional interbody fusion in posterior instrumentation for low-grade spondylolisthesis (grade I or II ). So, the purpose of this retrospective study was to compare the segmental sagittal angle in 35 patients of low-grade spondylolisthesis who was performed posterior instrumentation with or without posterial lumbar interbody fusion (PLIF) and to find out the risk factors of the loss of segmental sagittal angle in cases of posterior instrumentation without posterial lumbar interbody fusion (PLIF).
Body Weight ; Humans ; Kyphosis ; Pseudarthrosis ; Retrospective Studies ; Risk Factors ; Spondylolisthesis*

The anterior decompression and anterior interbody fusion have been the choice of surgical treatment for spinal tuberculosis since 1960. But, multi-level spinal tuberculosis involved more than three vertebrae resulted in large post-debridement defect and spinal instability. So, failure of the graft was very common & postoperative maintenance of the kyphotic angle correction was very difficult. In part of such cases as multi-level spinal tuberculosis, we performed supplementary anterior instrumentation in a single-stage procedure. The authors analyzed total 39 surgical cases of multi-level tuberculosis of the thoracolumbar spine from January 1985 to June 1992. The patients treated only with a strut graft were designated as group I(n=23) and the patients added by anterior instrumentation as group II(n=16). Mean age of 39 cases was 33.1 years, and mean follow-up period was 31.6 months. The purpose of this study was to compare the postoperative results of group I with those of group II by measuring the angular kyphosis on serial lateral roentgenograms, and to provide an aid in selecting method of surgery before treatment of multi-level spinal tuberculosis with high risk of progression of kyphosis. The results were as follows: 1. There were 16 cases of thoracolumbar, 14 cases of thoracic, 9 cases of lower lumbar lesions, and numbers of vertebrae involved were 4.2 in mean. 2. By standard Cobb lateral measurement, mean preoperative angle of segmental kyphosis was 32.5° in group I, and 45.1° in group II, and group II proved as more kyphotic. After operation, mean angle of segmental kyphosis was 24.7° in group I and 32.4° in group II. 3. On final F/U, mean angle of segmental kyphos was 32.7° in group I, and 37.3° in group II, and final loss of correction was 8.0° in group I, 4.9° in group II. 4. There were 8 patients(34.8%) of graft-related complications in Group I, and 2(12.5%) in group II. And graft failure in group I resulted in severe loss of correction of segmental kyphosis, but graft failure in group II did not, through graft protection by anterior instrumentation. 5. There were 3 patients(18.8%) of implant-related problems in group II; two during and one after union. In these former two cases, bony union was obtained without loss of correction by prolonged application of brace. No cases of group II was associated with persistence or recurrence of infection after instrumentation. In our opinion, anterior interbody fusion and combined anterior instrumentation can be effective and safe one of methods in surgical treatment for multi-level tuberculosis of the spine which has been considered as the most important determinant of the result by its extensive vertebral involvement with resulting large post-debridement defect to be struted.
Braces ; Decompression ; Follow-Up Studies ; Humans ; Kyphosis ; Methods ; Recurrence ; Spine ; Transplants ; Tuberculosis ; Tuberculosis, Spinal

Vertebral stabilization using transpedicular screw fixation device is widely used in the surgical treatment of degenerative lumber diseases such as spinal stenosis, pseudospondylolisthesis, and spinal instability. The use of transpedicular screw fixation devices provides substantial advantages with regard to an increase of the rate of solid arthrodesis, early rehabilitation, short segment spinal fusion, and restoration of sagittal lumbar lordosis. The authors analyzed 11 patients showing definite postoperative loss of the lumbar sagittal lordosis in a total of 110 surgical cases of degenerative lumbar diseases who underwent segmental spinal fusion using transpedicular screws from January 1981 to December 1993. The purpose of this study was to analyze the causes of loss of lumbar sagittal lordosis in the instrumented segments and to present some precautions in transpedicular screw fixation for surgical patients with degenerative lumbar spines to maintain corrected lumbar sagittal lordosis. The results from this study were as follows: 1. By standard Cobb lateral measurements, eleven cases in a total of 110 patients showed definite loss of lumbar sagittal lordosis more than 4 degrees. 2. The period reflecting loss of lordosis was roughly within postoperative four months which were critical fusion time of the grafted bone mass, which lasted an average of 4.8 months in this study. 3. The implants led to loss of lordosis consisted of 6 cases in 53 Diapasons, 4 cases in 32 Wiltses, and a case in 15 Steffee plate systems. Diapason & Steffee plate systems were classified as a rigid type and Wiltse system as a flexible one. 4. The causes of postoperative loss of lordosis were recognized as 2 cases of screw toggling, 5 cases of screw-rod locking failure and 4 cases of rod bending. 5. The group resulted in more loss of lordosis in degrees was related to significant change between preoperative and postoperative lordosis, distraction of disc space during operation, extensive discectomy, and reduction of degenerative spondylolisthesis which were the cases of the anterior column deficiency.
Animals ; Arthrodesis ; Diskectomy ; Humans ; Lordosis ; Rehabilitation ; Spinal Fusion ; Spinal Stenosis ; Spine ; Spondylolisthesis ; Transplants

alpha-hemolytic streptococci (AHS) are common normal oropharyngeal flora that can transfer antibiotic-resistance genes to Streptococcus pneumoniae. Reports on antibiotic resistance in AHS from throats are rare in Korea. A total of 333 healthy school children were subjected to recovery of AHS from the throat, and antibiotic susceptibility tests were screened with the disk diffusion method. The rate of resistance to erythromycin was 22.2%, to clindamycin 12.0%, and to cefotaxime 3.0%. Whereas the resistance rate of S. pneumoniae to erythromycin exceeds 70% in Korea, pharyngeal AHS showed low resistance rates.
Cefotaxime ; Child ; Clindamycin ; Diffusion ; Drug Resistance, Microbial ; Erythromycin ; Humans ; Korea ; Pharynx ; Pneumonia ; Streptococcus pneumoniae

BACKGROUND: The carrier study of group A streptococci (GAS), the most common cause of bacterial pharyngitis, is important to understand the epidemiology of GAS in the region. The authors performed throat cultures from the children of four elementary schools in Jinju area to investigate current microbiological characteristics in this area. METHODS: Throat cultures were taken from 2,351 healthy elementary school children (male 1,311 and female 1,040) from October through December, 2004. Two schools are located in rural areas, while the other two schools are in Jinju city. Beta-hemolytic streptococci (BHS) were identified with bacitracin disk (0.04 U) and latex agglutination test (Seroiden Strepto Kit, Eiken). RESULTS: Four-hundred forty-three (18.8%) yielded BHS from 2,351 school children. Serogrouping revealed 84.9% of group A, 5.9% of group C, 4.7% of group B, 3.6% of group G, and 0.9% of non-group A, B, C, G in a decreasing order. Isolation rate of GAS was similar between girls and boys. Children of elementary schools in rural areas showed significantly higher isolation rates (18.6-21.7%) compared to those (12.5-12.7%) in urban areas. CONCLUSION: The isolation rate of BHS was 18.8% in Jinju area, 2004. Group A was 84.9% and group C was next common. Although the isolation rate of GAS was similar by age or sex, it showed a significant difference by the location of the schools.
Bacitracin ; Child* ; Epidemiology ; Female ; Gyeongsangnam-do* ; Humans ; Latex Fixation Tests ; Pharyngitis ; Pharynx*

BACKGROUND: Serratia marcescens is a well-known cause of nosocomial infections. We investigated an outbreak of S.marcescens infections in a surgical intensive care unit (SICU) and identified the source of the outbreak using pulsed-field gel electrophoresis (PFGE). METHODS: A total of 39 isolates of S.marcescens were included in this study: 28 isolates from the patients in the SICU and epidemiologically-unrelated 11 isolates from the patients in the general wards from May through August, 2003 at Gyeongsang National University Hospital. Twenty-six of the 28 isolates in the SICU were from the urine collected from indwelling urinary catheters. Fifty-six environmental samples, such as the hands of healthcare workers and urinals were cultured to identify the source of infection. Antimicrobial susceptibility tests by Vitek GNS card (bioMerieux) and PFGE were performed to identify the clonality of the isolates. RESULTS: Twenty of the 28 S. marcescens isolated from the patients in the SICU showed the identical PFGE fingerprint pattern and two isolates had a closely-related pattern with the outbreak strain. The isolates from urine in the SICU were resistant to almost all the antibiotics tested except imipenem and cotrimoxazole. Nine of the 11 isolates from the general wards had PFGE patterns and antimicrobial susceptibility results different from those of the outbreak clone. Five samples from used-urinals and one from disinfected-urinal of 56 environmental samples grew S.marcescens that were resistant to the all antibiotics tested except imipenem and cotrimoxazole. CONCLUSION: The outbreak of urinary tract infections in SICU was due to a clonal spread of a single strain of S.marcescens that was multiple resistant to antibiotics except imipenem and cotrimoxazole. The source of outbreak appeared to be inadequately disinfected urinals.
Anti-Bacterial Agents ; Clone Cells ; Cross Infection ; Delivery of Health Care ; Dermatoglyphics ; Electrophoresis, Gel, Pulsed-Field* ; Epidemiology ; Hand ; Humans ; Imipenem ; Intensive Care Units* ; Critical Care* ; Patients' Rooms ; Serratia marcescens* ; Serratia* ; Trimethoprim, Sulfamethoxazole Drug Combination ; Urinary Catheters ; Urinary Tract Infections* ; Urinary Tract*

BACKGROUND: Erythromycin (EM) or other macrolides have been used commonly for the treatment of bacterial pharyngitis. Recently, however, EM-resistant group A streptococci (GAS) are being reported with increasing frequency. The phenotypic expression of macrolide resistance is classified as constitutive, inducible, and M. EM resistance is mediated by ermB, ermTR, or mefA genes. The emm gene encoding M protein has variable sequences at 5'end terminus. METHODS: GAS was isolated from patients with acute pharyngitis at a local clinic in Jinju from November 2001 to May 2002. Antimicrobial susceptibility testing was performed using the disk diffusion method. The phenotypes of EM and clindamycin (CC) resistance were evaluated, and the frequency of ermB and mefA genes was determined by PCR. The emm genotype was identified with PCR and sequencing. RESULTS: A total of 125 strains of group A streptococci was isolated. The resistance rate to EM and CC was 44.8% and 19.2%, respectively. Constitutive resistance was observed in 42.1%, M phenotype in 57.9%, but inducible resistance was not seen. The ermB and mefA genes were positive in 39.3% and 58.9%, respectively. Most emm12 strains showed constitutive resistance, while emm18 and emm75 showed M phenotype. CONCLUSIONS: The EM and CC resistance rates of group A streptococci isolated from acute pharyngitis were remarkably high compared to the previous reports. M phenotype was more common than constitutive resistance in acute pharyngitis. The resistance pattern was variable according to the emm types, suggesting an association between the emm gene and resistant genes.
Clindamycin* ; Diffusion ; Erythromycin* ; Genotype ; Gyeongsangnam-do ; Humans ; Macrolides ; Pharyngitis* ; Phenotype ; Polymerase Chain Reaction

BACKGROUND: M protein is the major virulence factor of group A streptococci (GAS). As the emm gene, which encodes the M protein, has a variable sequence at 5'-terminus by each M type, it can be classified into several restriction-fragment length polymorphisms (RFLP) by restriction enzymes. Pulsed-field gel electrophoresis (PFGE) is useful for investigating clonal outbreaks or bacterial transmission. Molecular epidemiological analysis using emm-RFLP and PFGE was performed on GAS isolated from bacteremia. METHODS: Twenty-eight strains of GAS isolated from patients with bacteremia were included. Medical records of 27 cases were reviewed retrospectively to see the prognosis of GAS bacteremia. The restriction patterns of emm gene digested with HaeIII enzyme were compared by each emm genotype. Macrorestriction patterns were produced by PFGE after digestion of chromosomal DNA with SmaI and ApaI enzymes. RESULTS: All but 2 cases with toxic streptococcal syndrome survived. The DNA fragments of emm-HaeIII restriction showed 3 to 4 bands. Each emm genotype showed a different emm-HaeIII restriction pattern, except emm49 and SP2346, of which the restriction pattern was similar to that of emm1. Thirteen different PFGE patterns were observed by SmaI, and emm6, emm12, and emm75 were not cut with SmaI. All 28 strains were cut with ApaI, which yielded 17 different PFGE patterns. All but emm13 showed a high concordance between the PFGE patterns and the emm genotypes. CONCLUSIONS: The patients with GAS bacteremia showed a relatively good prognosis. We found that the restriction enzyme analysis of emm gene was rapid, simple and inexpensive to perform, and that PFGE was useful for classifying GAS strains because it generally discriminated well between each emm genotype. Although the number of strains studied was small, GAS bacteremia was not due to a single clone.
Bacteremia* ; Clone Cells ; Digestion ; Disease Outbreaks ; DNA ; Electrophoresis, Gel, Pulsed-Field* ; Genotype ; Humans ; Medical Records ; Polymorphism, Restriction Fragment Length ; Prognosis ; Restriction Mapping ; Retrospective Studies ; Virulence