BACKGROUND: The recent surge of tuberculosis in association with AIDS and multi-drug resistant tuberculosis in the world has made even apparent the need for more rapid and accurate technologies of detecting and characterizing mycobacteria in the clinical microbiology laboratory. The BACTEC radiometric method which is known rapid alternative to traditional culture methods has been reported to be useful for the rapid detection and identification of mycobacteria from clinical specimens. I report the experience for the use of the BACTEC 460TB for detection of mycobacteria from clinical specimens. METHODS: All clinical specimens received in the department of clinical pathology from July 1993 through August 1994 were used for this study. Smears were prepared and stained for acid-fast bacilli(AFB) by Ziehl-Neelson method Middlebrook 7H12 medium(BACTEC 12A) containing a 14C-labeled palmitic acid was used as the basal medium. Quantitation of the liberated 14CO2 was used as a measure of cell growth. A BACTEC 460TB instrument was used for the detection and quantitation of 14CO2 liberated in the culture bottle. NAP tests for differentiating the M. tuberculosis complex from mycobacteria other than tuberculosis(MOTT) were performed. RESULTS: A total of 111(9.6%) mycobacterial isolates were recovered from 1.151 clinical specimens. The sensitivity of the BACTEC 460TB for detecting M. tuberculosis in acid-fast smear-positive specimens was 93.8%. The mean time required for the primary isolation of mycobacteria(GI of > or =10) was 9.8 days and the mean detection time of M. tuberculosis complex was 19.3 days. In according to the acid-fast smear results, the mean detection times of M tuberculosis complex in smear-positive and smear-negative specimens were 14.9 days and 20.9 days, respectively. The mean detection time of M. tuberculosis complex in smear-positive specimens was better for respiratory specimens(14.7 days) than for extrapulmonary specimens(21 days). All 111 isolates were susceptible to rho-nitro-alpha-acetylamino-beta-hydroxypropiophenone(NAP) and the contamination rate was 4%. CONCLUSIONS: The BACTEC radiometric method for detecting and characterizing mycobacteria requires expensive instrument and reagents using radioisotope and additional expenditure of time and effort, but The BACTEC 460TB is extremely useful for the rapid detection, isolation and identification of clinically important mycobacteria in clinical laboratory.
Health Expenditures ; Indicators and Reagents ; Mycobacterium tuberculosis* ; Mycobacterium* ; Palmitic Acid ; Pathology, Clinical ; Tuberculosis ; Tuberculosis, Multidrug-Resistant

This study was performed for the purpose of evaluation of plasma PGE2, levels in patients with gastric carcinomas. To carry out this study twenty-one gastrectomy patients with gastric carcinoma were selected. Serial plasma PGE2 levels were measured before and after operation by radioimmunoassay. Plasma PGE2 was also measured in five normal healthy volunteers or of patients with gastric ulcer. The conclusion drawn therefrom were as followed: 1) In normal healthy volunteers, plasma PGE2 level was 50.2+/-16.5 pg/ml which ws higher than that of parients with gastric ulcer, 20.7+/-15.4 pg/ml, (p<0.001). 2) In patients with diffuse type of gastric carcinoma, preoperative and postoperative plasma PGE2 levels were 25.7+/-12.1 pg/ml, and 23.1+/-8.7 pg/ml, rewpectively. In parients with intestinal type of gastric carcinoma, preoperative and postoperastive plasma PGE2 levels were 26.2+/-8.9 pg/ml and 24.1+/-11.2 pg/ml, respectively. In both types of gastric carcinoma, plasma PGE2 levels were lower than that of normal healthy volunteers and there was no significant difference compaired with the levels in patients with gastric ulcer. 3) In diffuse and intestinal types of gastric carcinoma, postoperative PGE2 levels were lower that those of preoperative state but it was not significant. 4) In early and advanced gastric carcinoma, preoperative PGE2 levels were 29.0+/-11.7 pg/ml and 24.8+/-9.9 pg/ml, respectively. There was no significant difference by the depth of invasion. From the result as mentioned above, it is concluded that plasma PGE2 levels of patients with gastric carcinoma and it is presumable that there is a factor decreasing plasma PGE2 levels in patients with gastric carcinoma or ulcer.

An extremely unusual case of epidermoid cyst showing diffuse parakeratosis and aggressive clinical behavior is presented. A destructive bone lesion with surrounding ill-defined soft tissue lesion was found by computed tomography in a 63 year-old man complaining of painful swelling of the right buttock. He had a history of surgical excision twice for epidermoid cysts of soft tissue of the right hip during recent one year. On aspiration cytology, the aspirate was highly cellular and mostly composed of desquamated nucleated squamous cells. Operation finding revealed that the iliac bone was irregularly destroyed and filled with gray-white cheesy material and necrotic bone debris. Adjacent gluteus muscle showed scattered gray-white lesions. The curettage specimen showed bone necrosis and desquamated squamous cells filling the marrow spaces. The lesion within muscle revealed epidermoid cyst with diffuse parakeratosis.
Child ; Male ; Female ; Humans ; Cysts

Nerve palsy as a complication of hematoma following total hip arthroplasty (THA) is a rare development. Although rare, this complication can cause permanent nerve palsy. The authors experienced a case of recovery from sciatic nerve palsy after emergency evacuation of a hematoma. The expanding thigh hematoma was due to anticoagulation treatment for prevention of venous thromboembolism after total hip arthroplasty. After 10 months from the operation, the patient regained complete motor power and leads an ordinary life. The authors would like to emphasize the danger of hematoma following anticoagulation therapy for prevention of venous thromboembolism after total hip arthroplasty.
Arthroplasty ; Emergencies ; Hematoma ; Hip ; Humans ; Paralysis ; Sciatic Nerve ; Sciatic Neuropathy ; Thigh ; Venous Thromboembolism

Idiopathic orbital myositis, a subgroup of inflammatory orbital pseudotumor may occur with acute-onset periorbital pain, diplopia, and, in most cases, eyelid swelling. Proptosis, extraocular muscle motility restrictions, and response to oral prednisolone administration were characteristic. Although the CT appearance of orbital myositis is often helpful, the findings are not pathognomonic: correlation with history, clinical finding, and therapeutic response must be considered in making the diagnosis. The results of corticosteroid therapy on the orbital pseudotumor caused by orbital myositis were as follows: 1. The effect of corticosteroid was more effective in single extraocular muscle involvement than in that of a multiple extraocular muscle. 2. Early age of onset and early treatment after symptom increased the effectiveness of corticosteroid therapy.
Age of Onset ; Diagnosis ; Diplopia ; Exophthalmos ; Eyelids ; Orbit* ; Orbital Myositis* ; Orbital Pseudotumor* ; Prednisolone

Although there have been a few reports of cases in which cancer cells of extrauterine origin were observed in vaginal smears, such findings are relatively uncommon. We recently experienced a case of ovarian serous cystadenocarcinoma diagnosed by cervicovaginal smear in a 56-year-old woman in routine work-up of carcinoma peritonei. The cellular features were several scattered cellular clusters of adenocarcinoma cells in clear background without tumor diathesis. Psammoma body was not present. Exploratory laparotomy confirmed the diagnosis of bilateral ovarian serous cystadenocarcinoma with multiple metastases.
Adenocarcinoma ; Cystadenocarcinoma, Serous ; Diagnosis ; Disease Susceptibility ; Female ; Humans ; Kidney Failure, Chronic* ; Laparotomy ; Middle Aged ; Neoplasm Metastasis ; Thyroid Gland ; Vaginal Smears

Germ cell tumors(GCT) are not infrequently encounted tumor in pediartic age group. In order to study the clinical behaviors of the disease, we reviewed 29 cases of GCT diagnosed and treated at Kosin Medical Center in the period of 7 years form Jan. 1984 to Dec. 1991 and the results are summarized as follows: 1) The age distribution is the highest between 10 and 15 years(45%) and girls have 1.9 times higher frequency than that of boys. 2) The most frequent primary site of GCT was ovary(15). The next common primary site was testis(5), pineal body(4), sacrococcygeal region(2), retroperitoneum(1), soft palate(1), anterior mediastinum(1) in descending order of frequency. 3) In the pathological analysis of tumors, the most frequent type was mature teratoma(12). The next common type was endodermal sinus tumor(6), immature teratoma(5), dysgerminoma(3), mixed type(2), and choriocarcinoma(1)in descending order of frequency. 4) All the 5 cases of EST have elevated serum levels of alpha-fetoprotein. Two of the three dysgerminoma, one of the two mixed type tumors both of which have germinoma components, and one choriocarcinoma have elevated serum levels of beta-HCG above the age related physiological levels. 5) Among 17 cases of malignant GCT, 9 cases have metastatic areas such as regional lymph nodes, scrotum, pleura, retroperitoneum, omentum and lumbar spine. 6) All except on case of immature teratoma in the anterior mediastinum underwent surgery. Chemotherapy was given to 12 of 17 malignant GCT and radiotherapy was given to 4 of 17 malignant GCT. 7) Among the 4 expired cases within 12 months of follow up, three were originated from pineal body, which had been underwent simple V-P shunt or incomplete resection, and one case was metastatic immature teratoma of anterior mediastinum to the pleura which had not been undergone surgery. Finally, in review of literature and or cases, the survival of properly managed GCT except some of those difficult surgical access is relatively good. To continue the survival of children of GCT to be impoved, we should use all the treatment modalit properly with more positive outlook about the disease.
Age Distribution ; alpha-Fetoproteins ; Child* ; Choriocarcinoma ; Drug Therapy ; Dysgerminoma ; Endoderm ; Female ; Follow-Up Studies ; Germ Cells* ; Germinoma ; Humans ; Lymph Nodes ; Mediastinum ; Neoplasms, Germ Cell and Embryonal* ; Omentum ; Pineal Gland ; Pleura ; Pregnancy ; Radiotherapy ; Scrotum ; Spine ; Teratoma

From March in 1991, central photorefractive keratectomy(CPRK) have performed to correct the 700 myopic eyes. With the example of 310 eyes posibly observed over 6 months after CPRK, studed whether it was corrected by retrospective examining. Especilly in the study of 150 patients collected by answering sheet then studied how discomfort they took through complication, and analyzed the cause of change and Indivisual degree of sansfaction with their myopic degree and postoperative permd. This study led to a conclusion that the milder myopia and the longer postoperative period, the more patients sansfaction increased. This is because the change of refractive power become stable and corneal haze decresase with time, Futhermore we dunk that corneal haze and regression occur more frequently in higher myopla, The CPRK is promising surgical treatment for patients with higher myopia but considerable further investigation and longer-term studies are needed to increase satisfaction.
Glare ; Humans ; Lasers, Excimer* ; Myopia ; Postoperative Period ; Retrospective Studies

We experienced an unusual case of acute encephalopathy in a 4 month-old boy He was admitted to our hospital because of lethargy and seizures after preceding symptoms of upper respiratory tract infection a few days before admission. On admission, he was in semicomatous mental state with decorticated rigidity. Laboratory tests showed normal blood sugar, ammonia, and transaminase levels. CSF was acellular and sterile. Brain MRI in both 71 and 72 weighted-image showed high signal density in both thalami and caudate nucleus head. After recovery, neurologic sequales of developmental delay, mental retardation, right hemiplegia and seizure remained. We report a case of acute encephalopathy that have clinical course similar to Reye syndrome but have specific brain image.
Ammonia ; Blood Glucose ; Brain ; Caudate Nucleus ; Head ; Hemiplegia ; Humans ; Infant ; Intellectual Disability ; Lethargy ; Magnetic Resonance Imaging ; Male ; Respiratory Tract Infections ; Reye Syndrome ; Seizures

Microcystic meningioma, a distinct morphological variant of meningiomas, is histologically characterized by a vacuolated appearance with multiple cystic spaces lined by vacuolated or stellate-shaped tumor cells. We report a case of microcystic meningioma occuring in right frontoparietal area of 42-year-old woman, with emphasis on differential diagnosis, along with a review of literatures. Immunohistochemically, most of the tumor cells demonstrated positive immunoreactivity for both epithelial membrane antigen and vimentin. Electron microscopy showed that the extracellular space was extensive, where eletron-lucent material was occasionally seen. The tumor cells had long cytoplasmic processes showing complex interdigitation and a large number of desmosomes.
Female ; Humans ; Diagnosis, Differential ; Meningioma