No abstract available.
Antibodies, Antineutrophil Cytoplasmic* ; Child* ; Humans ; Purpura, Schoenlein-Henoch*

BACKGROUND: Mycobacterial culture is a confirmatory test to detect the Mycobacterium tuberculosis, but it requires considerable time and the diagnosis and treatment may be delayed. The recently developed LCR (ligase chain reaction) is a more rapid and more specific test for the detection of M. tuberculosis. In this study, we compared the LCR results with those of the culture and AFB smear. METHODS: Mycobacterial culture was performed on 3% Ogawa media for 8 weeks. For LCR, we used LCx Mycobacterium tuberculosis assay kit (Abbott Laboratories, North Chicago, Ill.). The specimens for LCR were resuspended to LCx respiratory specimen resuspension buffer, and then separated mycobacterial DNA by ultrasonicator (Abbott LCx Lysor). Then the samples were mixed in amplification vial containing DNA polymerase and DNA ligase and amplified. For the detection, we used LCx analyzer from Abbott laboratories. RESULTS: The sensitivity, specificity, and positive and negative predictive values of the LCx M. tuberculosis assay were 95, 100, 100, 60%, respectively; 90, 100, 100, 42.9%, for culture; and 62.5, 100, 100, 16.7%, for acid-fast staining, respectively. The agreements between culture and LCx, smear and LCx, and culture and AFB smear were 86%, 65% and 60%, respectively. CONCLUSIONS: LCx was confirmed as a more rapid and sensitive test than the culture test and AFB smear.
Diagnosis ; DNA ; Mycobacterium tuberculosis ; Sensitivity and Specificity ; Tuberculosis*

BACKGROUND: Sometimes myelodysplastic syndrome (MDS) is especially difficult to distinguish from acquired aplastic anemia (AA) because of the clinical, cytologic, and histologic similarities of these two disorders. The proliferative activity of the hematopoietic cells is very different in various hematologic disorders and Ki-67 expression in the bone marrow cells is an useful cell proliferation marker. We tried to evaluate the significance of Ki-67/MIB-1 immunoreactivity in the discrimination of MDS and AA. METHODS: Bone marrow biopsy specimens from 56 individuals, 7 controls, 21 with MDS, 16 with AA and 12 with acute leukemia were obtained in Pusan Paik Hospital. Immunohistochemial staining for Ki-67 antigen was assessed by the MIB-1 monoclonal antibody using a microwave oven-based antigen retrieval technique. RESULTS: The mean values (+/-SD) of Ki-67 positive cells was as follows: control group, 16.8+/-3.6%; MDS, 25.3+/-10.1%; AA, 5.1+/-2.9%; acute leukemia, 30.5+/-10.4%. MDS cases showed statistically higher values of Ki-67 than did those of AA cases and control group (P<0.001) but no significance in Ki-67 frequencies was observed between the cases of MDS and acute leukemia. CONCLUSIONS: In the bone marrows of MDS cases the Ki-67 positive cells were frequently observed, suggesting high proliferative activity even in the nonleukemic state, while most of the bone marrows in AA showed very low proliferative activity. Thus immunohistochemical staining with Ki-67/MIB-1 would be useful in the discrimination of AA and MDS by the difference of Ki-67 positive cell percentage in the bone marrow.
Anemia, Aplastic* ; Biopsy* ; Bone Marrow Cells ; Bone Marrow* ; Busan ; Cell Proliferation ; Discrimination (Psychology) ; Humans ; Immunohistochemistry ; Ki-67 Antigen ; Leukemia ; Microwaves ; Myelodysplastic Syndromes*

In Korea, several outbreaks of low pathogenic AI (H9N2) viral infections leading to decreased egg production and increased mortality have been reported on commercial farms since 1996, resulting in severe economic losses. To control the H9N2 LPAI endemic, the Korea Veterinary Authority has permitted the use of the inactivated H9N2 LPAI vaccine since 2007. In this study, we developed a killed vaccine using a low pathogenic H9N2 AI virus (A/chicken/Korea/ADL0401) and conducted safety and efficacy tests in commercial layer farms while focusing on analysis of factors that cause losses to farms, including egg production rate, egg abnormality, and feed efficiency. The egg production rate of the control group declined dramatically 5 days after the challenge. There were no changes in feed consumption of all three groups before the challenge, but rates of the control declined afterward. Clinical signs in the vaccinated groups were similar, and a slight decline in feed consumption was observed after challenge; however, this returned to normal more rapidly than the control group and commercial layers. Overall, the results of this study indicate that the safety and efficacy of the vaccine are adequate to provide protection against the AI field infection (H9N2) epidemic in Korea.
Animals ; Chickens ; Emulsions ; Female ; Influenza A Virus, H9N2 Subtype/*immunology ; Influenza Vaccines/*immunology/*standards ; Influenza in Birds/immunology/prevention & control ; Oviparity ; Specific Pathogen-Free Organisms ; Vaccines, Inactivated/immunology

BACKGROUND: The operating room should provide an optimum environment that is safe for the patient and the working personnel. In this point of view, we investigated 8 items of temperature, humidity, air flow, noise, brightness, dust, CO2 and NO2. METHODS: Operating rooms, corridors and recovery rooms were tied as region I, II and III depending on their characteristics. 29 points were measured using appropriate instruments. After that, averaged values were calculated. RESULTS: Indoor climate (temperature, humidity and air flow) in region I were averaged 24.7, 65, 0.18/II were 25.5, 68, 0.18/III were 22.3 (degrees C), 56 (%), 0.22 (m/sec). Physcial condition (noise, brightness and dust) in region I were averaged 63, 295, 63/II were 67, 138, 87/III were 63 (db), 139 (lux), 26 (microgram/m3). Harmful gas (CO2 and NO2) concentration in region I were averaged 1152, 0.008/II were 913, 0.009/III were 1367 (ppm), 0.013 (ppm). CONCLUSIONS: Temperatures were appropriate but humidities were high except partial points. Air flow showed low values in average. Values of noise, dust and CO2 were relatively high. NO2 was low but brightness was variable. These mean that adequate improvement for quiet condition and air ventilation should be considered.
Climate ; Dust ; Humans ; Humidity ; Noise ; Operating Rooms* ; Recovery Room ; Ventilation

Langerhans cell sarcoma (LCS) is a neoplastic proliferation of Langerhans cells that have overtly malignant cytologic features. It is a very rare disease and theoretically, it can present de novo or progress from an antecedent Langerhans cell histiocytosis (LCH). However, to our knowledge, LCS arising from an antecedent LCH has not been reported on. We present here a case of LCS arising from a pulmonary LCH. A 34 yr-old man who was a smoker, had a fever and a chronic cough. Computed tomographic (CT) scan revealed multiple tiny nodules in both lungs. The thoracoscopic lung biopsy revealed LCH. The patient quit smoking, but he received no other specific treatment. One year later, the follow up chest CT scan showed a 4 cm-sized mass in the left lower lobe of the lung. A lobectomy was then performed. Microscopic examination of the mass revealed an infiltrative proliferation of large cells that had malignant cytologic features. Immunohistochemical stains showed a strong reactivity for S-100 and CD68, and a focal reactivity for CD1a. We think this is the first case of LCS arising from LCH.
Tomography, X-Ray Computed ; Sarcoma/*pathology ; S100 Proteins/biosynthesis ; Radiography, Thoracic ; Pancreatic Neoplasms/*pathology ; Male ; Langerhans Cells/*pathology ; Immunohistochemistry ; Humans ; Histiocytosis, Langerhans-Cell/diagnosis/*pathology ; Gene Expression Regulation, Neoplastic ; Antigens, Differentiation, Myelomonocytic/biosynthesis ; Antigens, CD1/biosynthesis ; Antigens, CD/biosynthesis ; Adult

BACKGROUND: Intrathecal (IT) magnesium has antinociceptive effects on animals and has been reported to prolong spinal opioid analgesia in humans. This study examined the effect of IT magnesium on spinal anesthesia and postoperative epidural analgesia. METHODS: Sixty patients undergoing total knee replacement were enrolled in this study. Before the IT injection of 0.5% isobaric tetracaine (10 mg), group C and group M received 0.9% saline or 50% magnesium sulfate 0.1 ml, respectively. The epidural solution for postoperative analgesia contained 0.2% ropivacaine (100 ml) only in group M, and 0.2% ropivacaine plus morphine (50microgram/ml) in group C. The verbal rating scale (VRS) scores for pain, sensory block level, intensity of motor block and side effects were recorded at 5, 60, and 120 minutes after the IT injection and at 1, 12 and 36 hours after surgery in the post-anesthesia care unit (PACU). RESULTS: The VRS score at 120 minutes after the IT injection were lower in group M than in group C (P< 0.05). There were no differences in the VRS scores and the use of supplemental analgesics at the postoperative period. The incidence of PONV, pruritus and urinary retention was significantly lower in group M than in group C at 12 and 36 hours after surgery. CONCLUSIONS: IT magnesium can be used as a local anesthetic adjuvant to strengthen the analgesic effect of spinal local anesthesia and to intensify the analgesic effect of epidural local anesthesia for postoperative pain control to the extent of 5 mg epidural morphine.
Analgesia ; Analgesia, Epidural ; Analgesics ; Anesthesia, Local ; Anesthesia, Spinal ; Animals ; Arthroplasty, Replacement, Knee ; Humans ; Incidence ; Magnesium Sulfate* ; Magnesium* ; Morphine ; Pain, Postoperative ; Postoperative Nausea and Vomiting ; Postoperative Period ; Pruritus ; Tetracaine ; Urinary Retention

BACKGROUND: Yersinia pseudotuberculosis, a member of genus Enterobactericeae, is a main etiologic organism of diarrhea in childhood. Because a mouse and a unchlorinated spring water are main reservoirs of Y. pseudotuberculosis, the strains from a contaminated spring water and mouse could be involved in human epidemic. The purpose of this study was to investigate a clonality between the strains from patients and those from an unchlorinated spring water and a mouse by restriction enzyme analysis of plasmid DNA and pulsed-field gel electrophoresis (PFGE). METHOD: We isolated 15 Y. pseudotuberculosis strains including 8 isolates from patients (S1-S8), 6 isolates from mountain water (W1-W6), 1 isolate from a mouse (M1) in northeast area of Seoul. Plasmid and chromosomal DNA of all strains were analyzed by REAP with Bam H1 restriction and by PFGE with Xba I restriction , respectively. RESULTS: Restriction enzyme analysis of plasmid DNA was classified into type B and type D. All 7 strains of serotype 15 were classified as type B and 8 strains of serotype 4b were classified as type D. PFGE were classified into 6 different types. Among them, strains of PFGE type I, II, III, IV belong to Y. pseudotuberculosis serotype 15 and Y. pseudotuberculosis 4b strains were classified into PFGE type V, VI. S1 and W1 were classified into PFGE type I . S8, W6 and M1 were classfied into PFGE type VI. CONCLUSIONS: PFGE revealed clonality among strains from patients, a water and a mouse. PFGE was more discriminative than REAP to characterize the Y. pseudotuberculosis outbreaks in Korea.
Animals ; Diarrhea ; Disease Outbreaks ; DNA* ; Electrophoresis, Gel, Pulsed-Field ; Humans ; Korea* ; Mice ; Plasmids* ; Restriction Mapping* ; Seoul ; Yersinia pseudotuberculosis* ; Yersinia*

No abstract available.
Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most frequent agents of hospital infections. The aim of this study was to evaluate the polymorphism of MRSA strains from our hospital by pulsed-field gel electrophoresis (PFGE) and ribotyping, and to compare effectiveness of two methods for epidemiologic investigation. METHODS: A total of 40 MRSA isolates were studied. All strains were isolated from patients from October 1990 to May 1995: 13 isolates from NS ward, 9 from GS and OS ward, 11 from medical ward, and 7 from other medical centers. All strains were analyzed and classified by ribotyping and PFGE patterns. RESULTS: Eight different ribotypes (H1-H8) and ten ribotypes (E1-E10) were seen by HindIII and EcoRI digestion. The problem was that some isolates showed discordance between classifications by HindIII and EcoRI digestion and three isolates from other medical centers had same ribotypes with that of our hospital strains. PFGE analysis revealed 19 different types (A to S). The PFGE analysis showed ward specificity, 54% of isolates from NS ward and 54% of isolates from medical ward were PFGE types D and J respectively, and 33% of isolates from GS and OS ward was H type and 33% was G type. CONCLUSIONS: PFGE was a more effective epidemiological tool for the typing of MRSA strains but a combination with ribotyping could provide more detailed strain differentiation.
Classification ; Cross Infection ; Digestion ; Electrophoresis, Gel, Pulsed-Field* ; Epidemiologic Studies* ; Humans ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Ribotyping* ; Sensitivity and Specificity