Functional-Below-Knee Total Contact Cast characterized by early weight bearing and free motion of affected knee joint during the cast immobilizaton has brought to significant result on trearment of tibial fractures, and is considered to take early bony union by establishment of almost physiological environment on fracture site during immobilization. For recent 2 years, writers have experienced many tibial fractures to treat with Functional Below-Knee Total Contact Cast. In them, clinical data and results of 17 cases which were studied well are reviewed, and method of cast application is illustrated.
Clinical Study ; Immobilization ; Knee Joint ; Methods ; Tibial Fractures ; Weight-Bearing

BACKGROUND: Urinary bladder cancer has been diagnosed by urine cytology and cystoscopy with biopsy. Recently, in vitro noninvasive diagnostic tests, measuring urinary nuclear matrix protein22(NMP22) and bladder tumor antigen(BTA), were introduced. We analyzed the usefulness of the NMP22 and BTA tests for diagnosing bladder cancer and compared those with voided urine cytology. MATERIALS AND METHODS: Single voided urine specimens were obtained from 27 patients with bladder cancer and 23 healthy volunteers. The urine specimens were assayed by enzyme immunoassay(NMP22, Matrietech(R), Newton, MA.) and latex immunoassay(BTA, Bard, USA). Urine cytology was performed in patients with bladder cancer. RESULTS: Mean urinary NMP22 level of patients with bladder cancer(144.6 U/mL) was significantly higher than those of normal controls(2.9 U/mL, P<0.01). The sensitivities were 89% and 74% for NMP22 and BTA tests, respectively, compared with 41% for voided urine cytology. The sensitivities of NMP22 and BTA tests were 88%, 63% at grade 1(G1), 82%, 73% at G2, and 100%, 88% at G3, respectively(P<0.01; NMP22, P=0.580; BTA). According to tumor stage, the sensitivities of NMP22 and BTA tests were both 79% at superficial, and 100% and 69% at invasive cancer, respectively(P=0.110; NMP22, P=0.678; BTA). The sensitivities of urine NMP22 and BTA tests combined with urine cytology were both 96%. In following of transitional cell carcinoma patients, agreement between urine cytology and BTA test was 75%(24/32). Among the various urologic disease, false positive rate for BTA test was 17%(8/47). CONCLUSION: Urinary NMP22 and BTA tests were more sensitive than voided urine cytology regardless of tumor grade and stage, so these noninvasive and simple tests can be used as screening tests for urinary bladder transitional cell carcinoma.
Biopsy ; Carcinoma, Transitional Cell* ; Cystoscopy ; Diagnostic Tests, Routine ; Healthy Volunteers ; Humans ; Latex ; Mass Screening* ; Nuclear Matrix ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urologic Diseases

PURPOSE: Accurate diagnosis of group A streptococcal(GAS) pharyngitis and appropriate antimicrobial therapy are important, particularly to prevent nonsuppurative sequelae and to reduce the improper use of antibiotics. Because the clinical presentation of pharyngitis does not reliably predict the etiologic agent, when GAS infection is suspected, diagnosis should be based on the result of a throat swab culture or antigen-detection test with culture back-up. METHODS: We reviewed retrospectively the medical records of children diagnosed as GAS pharyngitis by throat swab culture from Jan. 1995 to Jul. 2000. Since Nov. 1998, specimens were also tested with the Abbott's Testpack+plus Strep A Kit. RESULTS: 121 patients were confirmed as GAS pharyngitis by throat culture. GAS pharyngitis predominantly occurred from 3 to 7 years of age with the peak incidence at 4 and 5 years of age. The disease was more frequent in late fall, winter and spring. Clinical manifestations were as follows; fever(89.9%), abnormal pharynx(94.3%), of which exudate in 33.6%, sore throat(85.3%), headache(78.1%), cervical lymphadenopathy(67.5%), abdominal pain(64.3%), and nausea or vomiting (55.0%). The sensitivity and specificity of rapid antigen test compared to throat culture were 96.4% and 95%, respectively. CONCLUSION: GAS pharyngitis occurred every year, and more frequently in late fall, winter and spring. It occurred with the greatest frequency in preschool children. The rapid antigen test can be a basis for clinicians to decide how to treat their patients before the culture results are proven, and can be helpful to judicious use of antibiotics as well.
Anti-Bacterial Agents ; Child ; Child, Preschool ; Diagnosis ; Exudates and Transudates ; Humans ; Incidence ; Medical Records ; Nausea ; Pharyngitis ; Pharynx ; Retrospective Studies ; Sensitivity and Specificity ; Vomiting

OBJECTIVE: The purpose of this study was to evaluate the effect of hormone replacement therapy on endometrial thickness in postmenopausal women and to assess the difference in endometrial thickness by the type of hormone replacement therapy (HRT). MATERIALS AND METHODS: Endometrial thickness was measured in 258 postmenopausal women before and/or during 12 months of HRT. The subjects were grouped into the sequential therapy group (Group 1, 72 women) and continuous combined therapy group (Group 2, 186 women). Group 1 received 0.625 mg of conjugate equine estrogen (CEE) daily with cyclic addition of medroxyprogesterone acetate (MPA, 10 mg/day for 12 days per month). Group 2 received 0.625 mg of CEE with daily addition of MPA (2.5 mg/day). RESULTS: The sequential group showed no significant change in endometrial thickness during HRT compared to that before HRT. However, a significant increase in endometrial thickness was found in the continuous combined group at 12 months of treatment. Before HRT, the endometrial thickness in the continuous combined group was thinner than that of the sequential group. During 12 months of treatment, there was no difference in endometrial thickness between the types of HRT. And the proportion of patients with endometrial thickness of 8mm or greater at 12 months of treatment did not differ significantly from that before treatment in both groups. CONCLUSION: Sequential HRT did not influence the endometrial thickness during treatment. However, continuous combined HRT increased the endometrial thickness during 12 months of treatment compared to that before treatment. The different endometrial responses to each HRT regimen may be due to the difference in endometrial thickness before treatment in each group.
Estrogens ; Female ; Hormone Replacement Therapy* ; Humans ; Medroxyprogesterone Acetate

PURPOSE: Pneumonia is rather common and benign disease in children but its course is various. Many clinicians used the empirical antibiotics to treat pneumonia without identification of causative organism. This study was performed to find the pathogenic organism from the fluid culture by bronchoscopy with BAL (bronchoalveolar lavage) in severe pneumonia patients. METHODS: We studied 21 cases (male 15, female 6) who were admitted with severe pneumonia in the Department of Pediatrics, Sunlin Hospital from March to October in 1999. These patients had no underlying disease such as immunologic deficiency. We took laboratory tests including CBC, CRP, ESR, PB smear, mycoplasmal antibody and blood culture at admission day. We performed bronchoscopy with BAL, and wet smear and culture of that fluid. RESULTS: Organisms were cultured in nineteen cases out of 21 cases. Seven cases of Streptococcus mitis, five of Stenotrphomonas maltophilia, five cases of Streptococcus oralis, two of Moraxella species, two of Acinetobacter junii, one of Acinetobacter spesies, one Staphylococcus hominus, one alpha-h-Streptococcus, one Klebsiella pneumoniae, one Pseudomonas aeruginosa, one Enterobacter cloacae. Two organisms were cultured in nine cases. CONCLUSION: The positive rate of BALF culture was very high (90.5%). But, further studies are necessary for the patients with severe pneumonia preceded the use of antibiotics.
Acinetobacter ; Anti-Bacterial Agents ; Bronchoalveolar Lavage* ; Bronchoscopy ; Child ; Enterobacter cloacae ; Female ; Humans ; Klebsiella pneumoniae ; Moraxella ; Pediatrics ; Pneumonia* ; Pseudomonas aeruginosa ; Staphylococcus ; Streptococcus mitis ; Streptococcus oralis

BACKGROUND: A positive reaction at flow cytometry crossmatch (FCXM) has been highlighted by its predictive value for clinical outcome in kidney transplantation after accumulation of large clinical data. The detection of de novo development of anti-HLA antibodies after transplantation is associated with increased rejection and decreased graft survival. In this study, we report the experience for the detection of anti-donor specific antibody (DSA) by more sensitive FCXM methods in renal transplantation patients. METHODS: T and B cell FCXMs were performed on 11 pretransplant and 51 posttransplant sera from 11 patients who received renal grafts between 2004 and 2005. The posttransplant sera were collected in specific and regular intervals from posttranspant 1 week to 1 year. RESULTS: Among 62 sera, four (7.8%) from 2 patients showed positive FCXM. In one patient, pretransplant serum which was negative at previous CDCXM, and 2 consecutive sera collected at 1 week and 1 month after transplantation were positive at FCXM. And the antibody identified was B51 which was specific for one of donor alleles (DSA). In another patient, FCXM became positive 1 week after transplantation although pretransplant serum had negative results at both CDCXM and FCXM. Both patients had experienced more than one rejection episodes. CONCLUSIONS: Detection of DSA with more sensitive technique such as flow cytometry based method clearly displayed a beneficial effect for prediction of clinical outcome as a part of pretransplant compatibility test, and also as a posttransplant monitoring test to identify the de novo production of clinically significant DSA.
Alleles ; Antibodies ; Flow Cytometry ; Graft Survival ; Humans ; Kidney ; Kidney Transplantation ; Rejection (Psychology) ; Tissue Donors ; Transplants

Background: Danshen has been widely used in oriental medicine to improve body function. The purpose of this study is to investigate the effect of water-soluble Danshen extract (DE) on weight loss and on activation proteins involved in mitochondrial biogenesis in brown adipose tissue (BAT) in obese mice. Methods: BAT was isolated from 7-week-old male Sprague-Dawley rats, and expression of proteins related to mitochondrial biogenesis was confirmed in both brown preadipocytes and mature brown adipocytes treated with DE. For the in vivo study, low-density lipoprotein receptor knock out mice were divided into three groups and treated for 17 weeks with: standard diet; high fat diet (HFD); HFD+DE. Body weight was measured every week, and oral glucose tolerance test was performed after DE treatment in streptozotocin-induced diabetic mice. To observe the changes in markers related to thermogenesis and adipogenesis in the BAT, white adipose tissue (WAT) and liver of experimental animals, tissues were removed and immediately frozen in liquid nitrogen. Results: DE increased the expression of uncoupling protein 1 and peroxisome proliferator-activated receptor gamma coactivator 1-alpha in brown preadipocytes, and also promoted the brown adipocyte differentiation and mitochondrial function in the mature brown adipocytes. Reactive oxygen species production in brown preadipocytes was increased depending on the concentration of DE. DE activates thermogenesis in BAT and normalizes increased body weight and adipogenesis in the liver due to HFD. Browning of WAT was increased in WAT of DE treatment group. Conclusion DE protects against obesity and activates mitochondrial function in BAT.

No abstract available.
25-Hydroxyvitamin D 2/*blood ; Cholecalciferol/*blood ; Chromatography, High Pressure Liquid ; Humans ; *Radioimmunoassay ; Reagent Kits, Diagnostic ; *Tandem Mass Spectrometry

OBJECTIVE: To set up the methodology for PCR analysis of XbaI/intron 22 polymorphism of the factor VIII gene, and to identify the usefulness of XbaI/intron 22 polymorphism analysis for carrier detection and prenatal diagnosis of hemophilia A in the Korean population. DESIGN: A laboratory analysis. MATERIALS AND METHODS: A XbaI/intron 22 polymorphism of the factor VIII gene was analyzed in 56 unrelated Korean mothers of patients with severe hemophilia A, using polymerase chain reaction. RESULTS: Analysis of XbaI/intron 22 polymorphisms of the factor VIII gene were feasible by PCR method. The expected heterozygosity rates of XbaI/intron 22 polymorphism of the factor VIII gene were 44.8%. Analysis of XbaI/intron 22 polymorphism revealed heterozygous patterns in 22 (39.3%) of 56 mothers studied. Using linkage analysis with XbaI/intron 22 polymorphism, we have attempted one case of carrier detection and two cases of prenatal diagnosis in two families of patients with severe hemophilia A. CONCLUSION: These results suggest that PCR analysis of the XbaI/intron 22 polymorphism within the factor VIII gene is very useful in the carrier detection and prenatal diagnosis of hemophilia A in the Korean population.
Diagnosis* ; DNA* ; Factor VIII ; Hemophilia A* ; Humans ; Molecular Biology* ; Mothers ; Polymerase Chain Reaction* ; Prenatal Diagnosis

BACKGROUND: Determining the concentration profiles of serum 25-hydroxyvitamin D (25OHD) may aid in the clinical diagnosis and treatment of vitamin D deficiency. To date, the standardized liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay has been used for accurate and precise determination of 25-hydroxyvitamin D levels. Here, we evaluated the performance of the recently developed and introduced PerkinElmer Vitamin D kit and compared the measurements obtained by RIA and LC-MS/MS methods. METHODS: We evaluated the accuracy, precision, linearity, lower limit of quantification (LLOQ), recovery, and carry-over of the MSMS Vitamin D kit. Clinical specimens from 80 patients were used for the comparison between the MSMS Vitamin D kit (PerkinElmer, USA) and the RIA kit (DiaSorin, USA). RESULTS: The MSMS Vitamin D kit was found to produce intra-assay and inter-assay coefficients of variation (CVs) of less than 6% for precision and showed a bias of less than 5%. The MSMS Vitamin D kit displayed linearity within the range for total vitamin D levels of 4.5-150 ng/mL, and the lower limit of quantification for 25OHD was 0.38 ng/mL. The RIA measurements of 25OHD showed a correlation of y=0.9931x+0.2216 (r2=0.74) with the LC-MS/MS values. CONCLUSIONS: The LC-MS/MS assay of 25OHD3 and 25OHD2 showed excellent performance when using the MSMS Vitamin D kit and in terms of 4-phenyl-1,2,4-triazoline-3,5-dione (PTAD) derivatization. Further, the results obtained were well correlated with those obtained using the RIA method. Thus, assays using the MSMS Vitamin D kit are considered as more standardized, and they enable quicker and more accurate analysis and help reduce inter-laboratory variation than that by other existing methods.
25-Hydroxyvitamin D 2 ; Bias (Epidemiology) ; Calcifediol ; Humans ; Mass Spectrometry ; Tandem Mass Spectrometry ; Triazoles ; Vitamin D ; Vitamin D Deficiency ; Vitamins