BACKGROUND: The diagnosis of tuberculosis has been based on the detection of tubercle bacilli by acid-fast stain of smear or cultures, and recently the serologic diagnosis of tuberculosis has been provided a means of sensitive and specific detection of Mycobacterium tuberculosis. We evaluated the utility of enzyme immunoassay using determiner Tuberculosis Glicolipids(TBGL) antibody kit(Kyowa Medex Co. Ltd, Japan) to detect anti-TBGL antibody for diagnosis of pulmonary tuberculosis. METHODS: Anti-TBGL antibody assay was performed to the form 44 patients with active pulmonary tuberculosis(17 patients with smear positive, 7 patients with only culture positive, 20 patients with clinically active tuberculosis) and 80 controls (30 healthy controls, 24 patients with non-tuberculous respiratory diseases, 26 patients with inactive tuberculosis). We compared the sensitivity and specificity of anti-TBGL antibody with culture and AFB stain. RESULTS: Anti-TBGL antibodies were detected in 16 of 17(94%) smear positive patients, 4 of 7 patients with only culture positive and 16 of 20(80%) smear negative patients who had been clinically diagnosed as active pulmonary tuberculosis. Nine(35%) out of 26 patients with inactive tuberculosis, one(4%) out of 24 patients with non-tuberculous respiratory diseases and no one of healthy control had a positive antibody response. Overall sensitivity, specificity of the anti-TBGL antibody assay were 82%, 88%, respectively and sensitivities and specificities of culture and AFB smear 64%, 97%, and 49%, 100%, respectively. Anti-TBGL antibody titers in patients with active tuberculosis were significantly higher than control grup(P<0.05). Conclusions : The anti-TBGL antibody assay was sensitive, rapid and convenient. This assay will be useful as a tool for the diagnosis of tuberculosis in combination with other conventional methods.
Antibodies ; Antibody Formation ; Diagnosis* ; Humans ; Immunoenzyme Techniques* ; Mycobacterium tuberculosis ; Sensitivity and Specificity ; Tuberculosis ; Tuberculosis, Pulmonary*

BACKGROUND: Diet and weight concerns are commonplace and almost accepted features of life for girls during adolescence. Until recently, younger age groups haue largely been ignored, as these concerns were thought to be a product of pubertal development and sexual maturity. Girls under the age of fifteen therefore, have been assumed to be free of the pressures experienced by adult women. However, this belief is now hard to sustain. The object of the present study was to investigate the self-perception and body shape satisfaction in different weight categories of boys and girls aged 12-years old in Korea. METHODS: In May, 1995, one hundred and sixty seven boys and one hundred and twenty girls from two schools in Seoul completed assessments of body-esteem, self-esteem, body shape preference. The children's body weight and height were also measured. RESULTS: The heaviest children expressed the most discontent, having a low body-esteem, a desire for thinness. By the age of 12, girls boys already differ in their body shape satisfaction and differ in their body shape aspirations. There was a significant effect of weight category on the children's body esteem(boys(P =.005), girls(P=.0001). Children in both extreme categories, under-and over-weight, had lower body-esteem scores than those in other weight categories. However, it was the overweight children who had the lowest. reported body-esteem. Body esteem was highest among girls in the 'slightly underweight' category and highest among boys on the 'average weight' category. There was no effects of either weight category or gender on the childrens appraisal of self-esteem. A comparison of the points chosen on the silhouette scales to reflect current and preferred body shapes revealed clear gender differences. Of the girls, 63% placed their preferred body shape at a point thinner than their currently perceived shape, while only 15% chose a broader figure. In contrast,, 41% of the boys rated their preferred figure as broader than their current perception, and 37% as thinner than their current perception. CONCLUSIONS: This study has noted a relationship between body weight and self-perception in 12-year old children. The heaviest children expressed low body-esteem, a desire for thinness. This pattern was more characteristic of girls than boys. Even at this age, well before they have completed physical maturation, girls are aspiring to a body shape which is thinner than their average. This discontent experienced by the heaviest children on this sample was apparent in their lower body-esteem and the distance between their current and preferred body shapes. The girls preference was for thinness, while in the boys it was for a body shape which was broader than their current shape. From their responses, it would appear that the boys' desire was not for fatness, but for a more athletic and muscular build.
Adolescent ; Adult ; Aspirations (Psychology) ; Body Weight ; Child* ; Diet ; Female ; Humans ; Korea ; Overweight ; Self Concept ; Seoul ; Sports ; Thinness ; Weights and Measures

Comamonas testosteroni and Acinetobacter guillouiae are gram-negative bacilli of low virulence that are widely distributed in nature and normal flora. Despite their common occurrence in environments, they rarely cause infectious disease. We experienced a case of septic shock by C. testosterone and A. guillouiae, and isolated them by 16S ribosomal RNA sequencing method from the blood cultures of a previous healthy female during postoperative supportive care. This is the first case of septic shock required ventilator care and continuous renal replacement therapy due to these organisms in Korea.
Acinetobacter* ; Bacteremia ; Comamonas testosteroni* ; Comamonas* ; Communicable Diseases ; Female ; Humans ; Korea ; Renal Replacement Therapy ; RNA, Ribosomal, 16S ; Shock, Septic* ; Testosterone ; Ventilators, Mechanical ; Virulence

BACKGROUND: Many physicians hesitate to discuss do-not-resuscitate (DNR) orders with patients or family members in critical situations. In the intensive care unit (ICU), delayed DNR decisions could cause unintentional cardiopulmonary resuscitation, patient distress, and substantial cost. We investigated whether the timing of DNR designation affects patient outcome in the medical ICU. METHODS: We enrolled retrospective patients with written DNR orders in a medical ICU (13 bed) from June 1, 2014 to May 31, 2015. The patients were divided into two groups: early DNR patients for whom DNR orders were implemented within 48 h of ICU admission, and late DNR patients for whom DNR orders were implemented more than 48 h after ICU admission. RESULTS: Herein, 354 patients were admitted to the medical ICU and among them, 80 (22.6%) patients had requested DNR orders. Of these patients, 37 (46.3%) had designated DNR orders within 48 hours of ICU admission and 43 (53.7%) patients had designated DNR orders more than 48 hours after ICU admission. Compared with early DNR patients, late DNR patients tended to withhold or withdraw life-sustaining management (18.9% vs. 37.2%, p = 0.072). DNR consent forms were signed by family members instead of the patients. Septic shock was the most common cause of medical ICU admission in both the early and late DNR patients (54.1% vs. 37.2%, p = 0.131). There was no difference in in-hospital mortality (83.8% vs. 81.4%, p = 0.779). Late DNR patients had longer ICU stays than early DNR patients (7.4 ± 8.1 vs. 19.7 ± 19.2, p < 0.001). CONCLUSIONS: Clinical outcomes are not influenced by the time of DNR designation in the medical ICU. The late DNR group is associated with a longer length of ICU stay and a tendency of withholding or withdrawing life-sustaining treatment. However, further studies are needed to clarify the guideline for end-of-life care in critically ill patients.
Advance Directives ; Cardiopulmonary Resuscitation ; Consent Forms ; Critical Illness* ; Hospital Mortality ; Humans ; Intensive Care Units ; Resuscitation Orders* ; Retrospective Studies ; Shock, Septic

Five cases of histologically proven polymorphic reticulosis were examined with computed tomography(CT). CT findings were mucosal thickening along the septal and lateral walls of the nasal cavities(n=4), obliteration of the contour of the nasopharynx(n=4), involvement of the paranasal sinuses (n=2), destruction of the nasal septum and/or sinus walls(n=3) and mass in the palate, tonsil or neck (n=1). CT examination was helpful in determining the extent of the disease in the nasal cavity and paranasal sinuses. However, lesions in the palate and tonsils could not be easily evaluated with CT. CT findings of polymorphic reticulosis are nonspecific and granulomatous diseases may show similar CT findings.
Granuloma, Lethal Midline* ; Nasal Cavity ; Nasal Septum ; Neck ; Palate ; Palatine Tonsil ; Paranasal Sinuses

BACKGROUND: The triple marker test with maternal serum during 15-20 weeks gestation, based on AFP, hCG and uE3, is a useful screening technique for detecting chromosomal abnormalities and neural tube defect (NTD). However, the false positive rate has been reported from 4 to 8%. The purpose of this study was to evaluate whether or not women with a false positive result of the triple marker screening are at an increased risk for adverse outcomes other than chromosomal abnor-malities and NTD. METHODS: The study population was derived from 5,622 women undergoing triple marker screening at Mokdong Hospital between January, 1997 and August, 1999. A false positive was defined as a positive result of the triple marker test without further evidence of NTD or chromoso-mal abnormalities. The study group included 83 women whose results were a false positive and the 129 controls whose results were negative. The adverse outcomes included preterm delivery (<37 weeks), premature rupture of the membrane, pre-eclampsia, a low weight for the particular gesta-tion age (<10 percentile), a congenital anomaly and fetal death. RESULTS: The false positive rate of the triple marker test was approximately 1.5%. The overall inci-dence of adverse outcomes in the women with false positive result and those with a negative result were similar (30.1% vs 30.2%, respectively) (P > 0.05). However, adverse outcomes such as pla-cental abnormalities (8.4% vs 2.3%) and congenital anomalies (7.2% vs 0.8%) were more frequent in the women with a false positive result than women with a negative result s (P < 0.05). CONCLUSIONS: The results suggest that false positive results of the triple marker screening test do not appear to be associated with an increased risk for an adverse pregnancy outcome, but a careful evaluation for the placental and fetal abnormalities is necessary.
Chromosome Aberrations ; Female ; Fetal Death ; Humans ; Mass Screening* ; Membranes ; Neural Tube Defects ; Pre-Eclampsia ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Rupture

A CD7 positive acute leukemia, lacking CD4, CD8, CD3, CD13 and CD33 expression may include 4 categories; acute T-cell leukemia, mixed lineage leukemia, acute undifferentiated leukemia and CD7 positive acute myeloid leukemia. Therefore, the expression of cyCD3 or the presence of TCR gene rearrangement can make the diagnosis of acute T-cell leukemia. We report a patient with acute T-cell lymphoblastic leukemia, showing CD7+, CD4-CD8-, and CD3-expression and TCR gamma gene rearrangement.
Diagnosis ; Genes, T-Cell Receptor ; Genes, T-Cell Receptor gamma ; Humans ; Leukemia ; Leukemia, Myeloid, Acute ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma ; T-Lymphocytes

Severe sepsis and septic shock are the main causes of death in critically ill patients. Early detection and appropriate treatment according to guidelines are crucial for achieving favorable outcomes. Endotoxin is considered to be a main element in the pathogenic induction of gram-negative bacterial sepsis. Polymyxin B hemoperfusion can remove endotoxin and is reported to improve clinical outcomes in patients with intra-abdominal septic shock, but its clinical efficacy for pneumonic septic shock remains unclear. Here, we report a case of a 51-year-old man with pneumonic septic shock caused by Pseudomonas aeruginosa, who recovered through polymyxin B hemoperfusion.
Cause of Death ; Critical Illness ; Gram-Negative Bacteria* ; Hemoperfusion* ; Humans ; Middle Aged ; Polymyxin B* ; Polymyxins* ; Pseudomonas aeruginosa ; Sepsis ; Shock, Septic*

BACKGROUND: Hypoxic pulmonary vasoconstriction (HPV) is a defense mechanism to maintain adequate oxygenation. It has been reported that metabolism inhibition augments HPV. The purpose of the present study was, therefore, to determine the effect of metabolism inhibition on HPV in a rabbit model of isolated lung perfusion with exclusion of the influential factors on HPV. METHODS: In adult rabbits, lungs were isolated and perfused with a constant pulmonary perfusate flow. Acid-base status and temperature of perfusate was also constantly maintained. Thirty minutes after, the baseline hypoxic pressor response (HPR) was measured as the difference of pulmonary artery pressure (PAP) between a period of 21% normoxic gas inhalation and that of 3% hypoxic gas inhalation. After another thirty minutes, 2-deoxy-D-glucose 100 mg was mixed with the perfusate, and then HPR was measured three times. After checking metabolism inhibition effects, D-glucose 300 mg was mixed to the perfusate to reverse metabolism inhibition, and then HPR was measured three times again. RESULTS: Metabolism inhibition increased the basal PAP compared to the noninhibition state, but it didn't increase HPV response, so the peak PAP responding to hypoxic gas was the same as the noninhibition state. The absolute HPV response was decreased. After reversal of the inhibition state with a large amount of glucose, the basal PAP decreased to the original value and the HPV response recovered to the previous value. CONCLUSIONS: Deoxyglucose-induced metabolism inhibition increased the PAP ventilated with 21% O2, but it didn't increase the PAP ventilated with 3% O2. As a result, the absolute HPV response was decreased.
Adult ; Deoxyglucose* ; Glucose ; Humans ; Inhalation ; Lung* ; Metabolism* ; Oxygen ; Perfusion ; Pulmonary Artery ; Rabbits ; Vasoconstriction*

Aneurysms of the great vein of Galen are rare and the authors report a case of primary type aneurysm of the great vein of Galen. Clinicaly aneurysm of great vein of Galen give rise to different symptoms and signs at different age. New born infants have intractable heart failure, infancy have hydrocephalus, and adolescents have headache and syncope. The diagnosis rests upon angiography, especially four-vessel angiography is mandatary to delineate all of the feeding arteries. The posterior cerebral arteries supply most of the blood to the aneurysm. The only effective treatment is ligation of the feeding vessels at the point of entry into the vein of Galen.
Adolescent ; Aneurysm* ; Angiography ; Arteries ; Cerebral Veins* ; Diagnosis ; Headache ; Heart Failure ; Humans ; Hydrocephalus ; Infant ; Ligation ; Posterior Cerebral Artery ; Syncope ; Veins*