BACKGROUND: Mycobacterial culture is a confirmatory test to detect M.tuberculosis, but it takes at least 6 weeks to diagnose. PCR is a rapid and sensitive method, but it is known that PCR has a high false positive rate due to contamination, and a high false negative rate due to inhibitors. It is also known that LCR and PCR-Hybridization, recently developed methods, are more specific methods than PCR in terms of detection M.tuberculosis. In this study, we estimated the clinical utility of in house PCR, LCR and PCR-Hybridization for the detection of M.tuberculosis. METHODS: We evaluated 75 specimens, upon which M.tuberculosis culture based testing was requested, by PCR LCR, and PCR-Hybridization and compared results. Mycobacterial culture was performed on 3% Ogawa media for 8 weeks, and an in house PCR, LCx Mycobacterium tuberculosis assay kit(Abbott Laboratories, North Chicago, III) and the AMPLICOR M.tuberculosis test kit(Roche Molecular Systems, Inc. Branchburg, NJ, USA). RESULTS: In the view of the culture results, the sensitivities of the three tests were 40%, 80%, and 100% and their specificities were 98.6%, 94.3%, and 94.3%. CONCLUSION: LCR and PCR-Hybridization and rapid and sensitive methods for detecting M.tuberculosis in clinical laboratories.
Mycobacterium tuberculosis ; Polymerase Chain Reaction* ; Tuberculosis*

This study was designed to evaluate the partially purified antigens which were fractionated from crude extract of Paragonimus westermani and to monitor the enzyme-linked immunosorbent assay (ELISA) in experimental cat paragonimiasis during the course of infection as well as before and after chemotherapy. Crude extract of 6-month-old adult P. westermani was fractionated to 5 antigens by successive applications of ammonium sulfate precipitation, ion exchange chromatography and gel filtration. And the cats, 10 in each group, were infected with 60, 30, 15, and 5 metacercariae, then the half of each group was treated with praziquantel 2 times in one day of 100 mg per kilogram of weight on 150 days after the infection. Sera were collected every 10 days. ELISA was performed with the concentration of 2 microgram/ml antigen, 100 times diluted sera and 1,000 times diluted alkaline phosphatase conjugated anti-cat IgG. The results were as follows: Absorbance by ELISA with proteins precipitated by differential concentration of ammonium sulfate was the highest at 51-65 per cent precipitate (PA2), followed by 0-50 per cent precipitate (PA1), 66-80 per cent precipitate (PA3), and 81-90 precipitate (PA4). Unprecipitated protein over 90 per cent ammonium sulfate (PA5) showed the lowest antigenicity. Fractionation of PA1, PA2, and PA3 through the DEAE-cellulose column did not differentiate the antigenic proteins. By passing through the Sephadex G-200 column, PAl and PA2 were fractionated to high molecular weight proteins and those of low molecular weight which showed high absorbance by ELISA (PA1-I, II and PA2- I, II). But PA3 was shown to have a fraction of high molecular weight proteins (PA3-I) which showed high antigenicity. SDS-polyacrylamide gel electrophoresis of PA1-I, PA1-II, PA2-I, PA2-II, PA3-I, and crude extract was performed. Fraction PA1-I was composed of proteins which had the molecular weight of 270 kilodaltons (KD) to 196 KD; of them 220 KD protein was major band. Fraction PA2- I was composed of 255-225 KD, and PA3-I, 255-240 KD, respectively. Fraction PA1-II and fraction PA2-II consisted of 30 KD proteins. Absorbance by ELISA began to increase within 10-20 days after the infection and reached the highest on 140-180 days, then made plateau thereafter. Absorbance by ELISA decreased after praziquantel treatment. In 60 metacercariae infection group, the absorbance had been decreasing, but remained within the positive range during observation period, while those of 30, 15, and 5 metacercariae infection groups turned to negative range. Fraction PA1-II showed the highest antigenicity in ELISA, then fraction PA2-I, fraction PA1-I , fraction PA2-II, fraction PA3-I and crude extract followed. In early phase of infection, the absorbance of fraction PA1-II showed more rapid increase than those of the other fractions and it came to positive range at 20-30 days after infection.
parasitology-helminth-trematoda ; immunology ; enzyme-linked immunosorbent assay ; Paragonimus westermani ; antigen

PURPOSE: Peyronie's disease is characterized by the presence of one or more fibrous plaques in the tunica albuginea or intercavernous septum, that is a slowly evolving disease which may cause a bending of the penis as well as pain during erection. Despite its self-limiting nature in many patients, a few patients will eventually require therapies if deformity or impotence is severe and conservative cares have failed. Currently numerous surgical and non-surgical therapies have been used for Peyronie`s disease. In this study we evaluated the effectiveness of oral medication in the treatment of Peyronie`s disease. MATERIALS AND METHODS: We analyzed retrospectively 123 patients with Peyronie`s disease treated with oral medication in the period of 1991-1997. 20 patients were observed without medication. 23 patients were treated with oral prednisolone, 22 patients with oral vitamin E, 40 patients with oral prednisolone and vitamin E, and 18 patients with potassium p-aminobenzoate(Potaba). RESULTS: Age distribution of patients was 23-84 years(mean: 51.4 years). Chief complaints were curvature of the penis during erection for 82% of the patients, painful erection for 66%, and problems with sexual intercourse for 34%. Average size of the plaques was 6.25cm2. The average duration of symptoms was 12.5 months. With prednisolone, curvature of penis during erection, plaques and painful erection were improved 55.6%, 57.1% and 86.7% respectively. With vitamin E, clinical results were reported 65.0%, 66.7% and 73.3% and with prednisolone and vitamin E 70.9%, 79.5% and 78.6% and with Potaba 81.3%, 82.4% and 90.9%. No patients with sexual dysfunction experienced improved sexual function. No serious side effects were observed in any of our patients. CONCLUSIONS: With these results, it can be concluded that the distressing symptoms of Peyronie`s disease can be treated with oral agents. Oral medication therapy may be a safe, noninvasive therapeutic alternative treatment method in patients with Peyronie`s disease but further studies were need to evaluate the effectiveness compared with intralesional injection therapy or surgery for Peyronie`s disease.
4-Aminobenzoic Acid ; Age Distribution ; Coitus ; Congenital Abnormalities ; Erectile Dysfunction ; Humans ; Injections, Intralesional ; Male ; Penile Induration* ; Penis ; Potassium ; Prednisolone ; Retrospective Studies ; Vitamin E ; Vitamins

PURPOSE: To evaluate the spherical aberrations of the anterior and posterior surfaces of normal corneas using Pentacam in a Korean sample population and determine their ranges and changes with age. METHODS: We used Pentacam (Oculus Inc.,Germany) to measure the anterior and posterior corneal spherical aberrations of 240 eyes in 240 patients with normal corneas who visited our clinic. The means and ranges of spherical aberrations and their changes with age were determined. We examined both eyes of 90 patients to confirm the inter-ocular symmetry in spherical aberration. RESULTS: The mean age of the 240 patients (M:F=103:137) was 49.8 years (range: 20-79), and the mean spherical aberrations of the anterior and posterior surfaces of the cornea were 0.230+/-0.078 micrometer, and -0.04+/-0.021 micrometer, respectively. The mean total corneal spherical aberration was 0.19+/-0.087 micrometer. There were no differences between males and females, and inter-ocular symmetry was observed in all tested patients. There was a tendency for the values of anterior, posterior and total corneal spherical aberration to increase with age. Ranges of spherical aberrations were from -0.177 micrometer to 0.423 micrometer in the anterior cornea, from -0.083 micrometer to 0.034 micrometer in the posterior cornea, and from -0.238 micrometer to 0.410 micrometer in the total cornea. CONCLUSIONS: In a Korean population, the mean total corneal spherical aberration was 0.19 micrometer, which was shown to increase with age. Some patients were shown to have an extreme value. Based on these results, a preoperative analysis for corneal spherical aberration may be helpful when selecting aspheric intraocular lenses.
Cataract ; Cornea ; Eye ; Female ; Humans ; Lenses, Intraocular ; Male

PURPOSE:To report 2 cases of corneal melting and corneal melting with descemetocele that occurred in users of cosmetic contact lenses. CASE SUMMARY: A-12-year-old and a 13-year-old female who used cosmetic contact lenses were referred to our clinic under the preliminary diagnosis of keratitis and corneal melting. The patients had purchased the lenses from an optician and had worn the lenses for approximately 1 month without being educated on their proper use. The signs and symptoms improved after 2 weeks of treatment with oral steroid and 1% topical prednisolone acetate. However, descemetocele occurred in the 12-year-old patient. Reepithelization of the cornea had been completed within the treatment period. However, corneal thinning with mild opacity remained in the lesions, and the best corrected visual acuities on the Snellen chart were 20/30 in both patients.
Adolescent ; Child ; Contact Lenses ; Cornea ; Cosmetics ; Female ; Freezing ; Humans ; Keratitis ; Prednisolone ; Visual Acuity

OBJECTIVE: The exact position of the lesion during the pallidotomy is critical to obtain the clinical improvement of parkinson's disease without damage to surrounding structure. Ventriculogrphy, CT(computed tomograpy) or MRI(magnetic resonance imaging) have been used to determine the initial coordinates of stereotactic target for pallidotomy. The goal of this study was to determine whether microelectrode recording significantly improves the neurophysiologic localization of the target obtained from MRI. METHODS: Twenty patients were studied. They underwent a unilateral pallidotomy. Leksell frame was applied and T1 axial images parallel to the AC-PC(anterior commissure-posterior commissure) plane using a 1.5 Tesla MRI with 3mm slice thickness were obtained. Anteroposterior coordinate of target was chosen at 2mm in front of the midcommissural point and lateral coordinate between 19 and 22mm from the midline. The vertical coordinate was calculated on coronal slice using a fast spin echo inversion recovery sequence(FSEIR) related to the position of the choroidal fissure and ranged over 4-5mm below the AC-PC plane. Confirmation of the anatomical target was done on axial slices using the same FSEIR sequence. Microrecording was done at the pallidum contralateral to the symptomatic side using an electrode with a tip diameter of 1nm diameter tip and 1.1-1.4 mOhm impedance at 1000Hz. Electrophysiologic localization of the target was also confirmed intraoperatively by macrostimulation. RESULTS: Microrecording techniques were reliable to define the transition from the base of the pallidum which was characterized by the disappearance of spike activity and by the change of the audible background activity. Signals from high amplitude neurons firing at 200-400Hz were recorded in the pallidal base. X, Y and Z coordinates of target obtained from the MRI were within 1mm from the X, Y, Z coordinates obtained with microrecording in 16 patients (80%), 15 patients(75%), 10 patients(50%) respectively. The difference of Y coordinate between on MRI and on microrecording was 4mm in only one patient. CONCLUSION: The MRI was accurate to localize the target within 1mm of the error from microrecording target in 70% of the patients. 4mm discrepancy was observed only once. We conclude that MRI alone can be used to determine the target for pallidotomy in most patients. However, microrecording technique can still be extremely valuable in patents with aberrant anatomy or unusual MRI coordinates. We also consider physiologic confirmation of the target using macrostimulation to be mandatory in all cases.
Choroid ; Electric Impedance ; Electrodes ; Fires ; Humans ; Magnetic Resonance Imaging* ; Microelectrodes ; Neurons ; Pallidotomy* ; Parkinson Disease*

Metastatic adenocarcinoma to the brain usually appears low-to-moderate attenuation on non-enhanced computed tomography. However, metastatic mucinous adenocarcinoma shows strikingly high attenuation, even simulating hemorrhage in some cases. We present a rare case of a mucin-containing metastatic adenocarcinoma of the rectum mimicking cerebral hemorrhage.
Adenocarcinoma ; Adenocarcinoma, Mucinous* ; Brain ; Cerebral Hemorrhage* ; Hemorrhage ; Mucins* ; Rectum

PURPOSE: To report a case of isolated posterior capsule rupture (PCR) with cataract after blunt ocular trauma in a child. METHODS: A 6-year-old female visited our institution complaining of blurred vision (best corrected visual acuity: counting fingers at 30 cm) in the left eye three months after blunt ocular trauma. Slitlamp examination showed the cataract and PCR with intact anterior capsule. Removal of the cataract was approached via a scleral tunnel incision. Anterior vitrectomy was performed and a foldable intraocular lens (IOL) was inserted in the sulcus. RESULTS: Visual acuity was improved to 0.7 two days after the surgery and further improved to 1.0 at two months. CONCLUSIONS: An isolated PCR with cataract is a rare complication of blunt ocular trauma. We present a case of PCR after blunt ocular injury as well as a surgical procedure to safely remove the cataract via an anterior approach and implantation of the IOL in the sulcus.
Cataract ; Child* ; Female ; Fingers ; Humans ; Lenses, Intraocular ; Polymerase Chain Reaction ; Rupture* ; Visual Acuity ; Vitrectomy

PURPOSE: This study is a retrospective analysis of patients who had undergone surgical treatment for non-union of distal humerus fracture. We evaluated them in terms of causes of injury, radiologic findings, and clinical outcomes such as prognosis. MATERIALS AND METHODS: Seven consecutive radiologic patients who were confirmed to have nonunion of a distal humerus fracture underwent reoperations. These patients had already undergone operations for distal humerus fractures. This survey was held from 2005 to 2010. The average period up to diagnosis of non-union after the first operation was 7.4 months (4 to 16 months). The mean follow-up period was 24.6 months (12 to 65 months). Each patient was graded functionally according to the Mayo Elbow Performance Score and the Disabilities of the Arm, Shoulder and Hand Score. RESULTS: Osteosynthesis was performed by internal fixation with plates and screws and then a bone graft for non-union of the distal humerus fracture. The average range of motion within the elbow joints was found to be a flexion contracture of 18.8 degrees (0~30 degrees) and further flexion of 120.2 degrees (102~140 degrees). Among postoperative complications, three cases of medium-degree stiffness, two cases of medial column nonunion, and one case of dissociation of the internal fixator were reported. CONCLUSION: Stable internal fixation for maintenance reduction status is essential after accurate initial anatomical reduction. We concluded that nonunion could be prevented by additional surgical treatment such as autogenous bone graft, if it is necessary.
Arm ; Contracture ; Dissociative Disorders ; Elbow ; Elbow Joint ; Follow-Up Studies ; Hand ; Humans ; Humerus ; Internal Fixators ; Postoperative Complications ; Range of Motion, Articular ; Retrospective Studies ; Shoulder ; Transplants

A 29-year-old woman in her 8th week of pregnancy was referred to our hospital for swelling in the lower extremities, rapid onset of dyspnea (1 hr) and pre-syncope. Severe right ventricular dysfunction and moderate pulmonary hypertension were detected using 2-dimentional Doppler echocardiography. In addition, left calf vein and proximal thromboses were detected by venous compression ultrasound imaging. After successful thrombolytic treatment, the patient quickly recovered and was discharged from hospital on subcutaneous low-molecular-weight heparin. She delivered a normal, healthy infant at full-term (40 weeks).
Adult ; Dyspnea ; Echocardiography, Doppler ; Female ; Heparin, Low-Molecular-Weight ; Humans ; Hypertension, Pulmonary ; Infant ; Lower Extremity ; Pregnancy* ; Pulmonary Embolism* ; Thrombolytic Therapy ; Thrombosis ; Ultrasonography ; Veins ; Venous Thrombosis* ; Ventricular Dysfunction, Right