No abstract available.
Travel Medicine

No Abstract available.
Korea*

BACKGROUND: The enteroviruses are the most common etiologic agent of aseptic meningitis in adults and children. The incidence of enteroviral meningitis in childhood meningitis is up to 80%, but in adults is not known, worldwidely. In Korea, where tuberculosis is endemic, the rapid and accurate diagnostic method for enteroviral meningitis is required especially because early differential diagnosis of viral meningitis from tuberculous meningitis is very important. The aims of this study were the demonstration of enteroviruses from cerebrospinal fluid (CSF) of adult patients with aseptic meningitis by PCR/Southern hybridization and the verification of the usefulness of PCR/southern hybridization as a rapid diagnostic tool. METHODS: From July 1992 to June 1995, total 34 CSF samples (10 from children, 24 from adults) of patients with aseptic meningitis were studied. As a control group, 15 patients with tuberculous meningitis and 15 patients with bacterial meningitis were studied. Viral RNA was extracted from CSF, reverse transcriptied into cDNA and amplified. The PCR products were Southern hybridizied with enteroviruses-specific digoxigenin-labelled probe. RESULTS: 16/24(66.7%) samples of adult patients with aseptic meningitis were positive for enteroviruses, while in child patients with aseptic meningitis, 9/10(90%) samples were positive. And in one patient, PCR was positive from asymptomatic, onset-7th day CSF sample. CONCLUSION: Enteroviruses were the most common causative organisms of adult aseptic meningitis in Korea. And, this study showed the usefulness of PCR/Southern hybridization of enteroviruses from CSF for etiologic diagnosis of adult aseptic meningitis in subclinical, asymptomatic period.
Adult* ; Cerebrospinal Fluid* ; Child ; Diagnosis ; Diagnosis, Differential ; DNA, Complementary ; Enterovirus* ; Humans ; Incidence ; Korea ; Meningitis ; Meningitis, Aseptic* ; Meningitis, Bacterial ; Meningitis, Viral ; Polymerase Chain Reaction ; RNA, Viral ; Tuberculosis ; Tuberculosis, Meningeal

A 21-year-old female is presented with semicircular lipoatrophy, which had developed since birth with annular depressed strophic lesion of the left thigh. Biopsy specimen from the depressed area of left thigh showed no abnormal pathologic findings. But X-ray and CT scan of the lower extremity revealed remarkably reduced fat layer of the left thigh, compared to the right side.
Biopsy ; Female ; Humans ; Lower Extremity ; Parturition ; Thigh ; Tomography, X-Ray Computed ; Young Adult

No abstract available.

One of various decompression methods in treatment of spinal stenosis is the indirect instrumental decompression. Theoretically, the distraction of the disc space can widen the intervertebral foramen of the stenotic segment and even increase the canal diameter by distracting the posterior annulus as well as reduce the extent of decompressive laminectomy site. The indirect instrumental decompression, however, was not guaranteed to maintain the restored discal height because of the loss of fixation strength between rod and screw, viscoelasticity of vertebra itself, bone density, type of screw and rod, and operative technique. As well the magnitude of the stresses on the instrumentation particularly at the rod-screw interface may depend on rod-contouring in order to make mormal sagittal curvature of the lumbar spines. Therefore, the aim of this experimental study was to evaluate the effect of different rod-contour on the axial sliding strength in Compact Cotrel-Dubousset (CCD) instrumentation. Axial sliding strength was tested by Universal Test Machine (Instron). Test was performed for 3 groups of different rodcontouring on the biomechanical axial strength: straight rod (no contour), 10 and 20 contouring rod. The length of contact surface between rod and screw was measured with Fuji pressure sensitive film. The study was performed using 6.5 mm open body screws and 7 mm rods of CCD instrumentation. Axial sliding strength of straight rod was 2518.6N, 1871.8N in 10 and 1528.8N in 20 contouring rod. The length of contact surface between rod and screw significantly decreased according to degree of rod contouring; 9.88mm in straight rod, 9.08mm in 10 and 8.57mm in 20 contouring rod. There was a statistically significant linear correlation (R=0.96) between failure load and length of contact surface. Therefore, this study has shown that excessive contour of the rod in order to make normal sagittal curvature of the lumbar spine using CCD instrumentation cannot provide sufficient axial sliding strength. That may be a cause of loss of restored disc space height after surgery.
Bone Density ; Decompression ; Laminectomy ; Spinal Stenosis ; Spine

Background: The purpose of this study was to identify the distribution characteristics of radiological damage to the hand of rheumatoid arthritis patients and evaluate its effectiveness using a new damage assessment method. Methods: Hand radiographs of a total of 127 rheumatoid arthritis patients were evaluated. We simplified the pre-existing van der Heijde modified total sharp score to assess the extent of bone damage. We selected 36 joints in both hands as regions of interest in our own way, and the erosion and joint space narrowing were scored. Results: When the erosion and joint space narrowing score values of each joint of the hand were added together, the joint space narrowing score was higher than the overall erosion score. We can see that the scaphoid,lunate,radius and ulnar joints have higher erosion scores, and the 4th proximal interphalangeal (PIP), Scaphoid, Lunate, and Radius joints have higher joint space narrowing scores than other joints. These damage assessment results were similar to the results from the previous damage assessment model. Conclusions The joint space narrowing score is higher than the erosion score, suggesting that joint space narrowing precedes erosion. When checking the hand X-ray of rheumatoid arthritis patients, it is necessary to carefully check the scaphoid,lunate,radius and ulnar and 4th PIP joints, which relatively high radiographic damage scores. Also, the damage assessment model used in this study is relatively simple and does not show difference in analysis results from existing assessment models, so it can be considered for application in follow-up research.

BACKGROUND: During the last three decades, the resistance of S. pneumoniae to penicillin has been rapidly increasing in many parts of the world, especially in Korea. To characterize the clinical features and epidemiology of penicillin-resistant S. pneumoniae (PRSP) infections in the community and hospital, as well as to investigate the possible spread of resistant clone, we performed the antimicrobial susceptibility tests, pulsed filed gel electrophoresis (PFGE) and penicillin-binding protein (PBP) profile analysis of PRSP isolates. METHODS: A total 48 PRSP isolates from patients who visited or were admitted to Korea University Guro hospital during the period form July 1998 to June 1999 were studied. Anitimicrobial susceptibility tests for 48 isolates were performed with microbroth dilution method to determine the minimal inhibitory concentration of 11 antibiotics. 39 isolates and 35 isolates were subjected to PFGE and PBP profile analysis, respectively to investigate the genetic relatedness between PRSP isolates. RESULTS: Pneumonia was most common site of infection in the community and the hospital as 50%. There were no significant differences of clinical features and prognosis between community and hospital isolates. But, patients with serious underlying diseases had poor prognosis despite of acquisition site. High level penicillin resistance were observed in 69%, multi-drug resistance were 64.6% of isolates. PFGE showed that 13 of 29 community acquired infection were identical PFGE pattern but not that of 23F Spanish clone. There were various PFGE patterns were observed from community and hospital acquired infection isolates. Some of them were existed in both. PBP profiles showed more diverse, even if in isoaltes of the same PFGE pattern. CONCLUSOIN: In our study, high level penicillin resistance and multi-drug resistance were observed in PRSP clinical isolates. No clinical and prognostic differeces were observed between community and hospital acquired infections. Molecular epidemiology study were suggest the there were various genotypes of PRSP within our society. Some of them were observed in the hospital and community. Therefore, there was an evidence of communication of PRSP clones between the community and hospital.
Anti-Bacterial Agents ; Clone Cells ; Drug Resistance, Multiple ; Electrophoresis ; Epidemiology ; Genotype ; Humans ; Korea ; Molecular Epidemiology ; Penicillin Resistance ; Penicillin-Binding Proteins ; Penicillins ; Pneumonia ; Prognosis ; Streptococcus pneumoniae* ; Streptococcus*

Non-typhoidal Salmonella (NTS) is an important commensal microorganism. The purpose of this study was to determine the epidemiological relation between NTS isolates from livestock and NTS isolates from human by analyzing antimicrobial susceptibilities and performing molecular typing. We determined the serotypes of 36 human clinical isolates and 64 livestock isolates, performed antimicrobial susceptibility testing against 8 antibiotics, and determined the molecular types of isolated NTS spp. by pulsed field gel electrophoresis (PFGE). In human isolates, S. enteritidis was the most common serotype (17 isolates; 47.2%) and S. typhimurium the second most (8 isolates; 22.2%). In livestock isolates, S. typhimurium was the most common serotype (15 isolates; 23.44%), and S. enteritidis was the second most (14 isolates; 21.88%). Ampicillin and tetracycline resistance were 50% (32/64 isolates) each among broiler-chicken NTS isolates. No human or livestock NTS isolates showed resistance to ciprofloxacin, TMP-SMX, or ceftriaxone. However, 19.4% (7/36) and 46.8% (30/64) of the human and livestock NTS isolates were resistant to nalidixic acid (MIC > or =16 mg/mL), respectively. The presence of the three identical PFGE molecular types from human and broiler-chicken NTS isolates suggests the possibility of transmission from livestock to humans.
Adult ; Animals ; Chickens ; Cluster Analysis ; Drug Resistance, Bacterial ; Female ; Humans ; Korea ; Male ; Nalidixic Acid/pharmacology ; Salmonella Infections/epidemiology/metabolism/*microbiology ; Salmonella Infections, Animal/epidemiology/metabolism/*microbiology ; Salmonella enteritidis/metabolism ; Salmonella typhimurium/*metabolism ; Serotyping

We reviewed the clinical features, histrologic patterns and clinical courses of 30 children with lupus nephritis retrospectively, and the results were summerized as follows; 1) The male to female ratio was 1:2.8, and the mean age at the onset was 10 8/12 years. 2) The clinical symptoms were diverse, and malaise, weight loss, anorexia, fever and malar rash were the most frequent findings. 3) Among the immunologic tests, FANA and anti-ds-DNA test revealed the highest sensitivity with positive rates of 97% and 87%, respectively. 4) Clinically, 57% of patients had active nephrotic syndrome at the onset, and 33% showed (?) was the most common findings (70%). 5) During the follow-up period, one children with Class IV lupus nephritis expired. And 8 out of 9 cases with renal insufficiency at the onset showed improvement of renal function after treatment with corticosteroid and cytotoxic agents. In conclusion, the clinical features and histologic findings of lupus nephritis in children were diverse. Early diagnosis and proper treatment can prevent rapid deterioration of renal function and improve long-term survival rate.
Anorexia ; Child* ; Cytotoxins ; Early Diagnosis ; Exanthema ; Female ; Fever ; Follow-Up Studies ; Humans ; Immunologic Tests ; Lupus Nephritis* ; Male ; Nephrotic Syndrome ; Renal Insufficiency ; Retrospective Studies ; Survival Rate ; Weight Loss