No abstract available.
Child* ; Endoscopy* ; Gastrointestinal Diseases* ; Humans

The authors experienced a case of orbital neurilemoma, which is a rare benign tumor of the orbit, in a 31-year-old Korean female. At her first visit, she complained of decreased visual acuity for 3 years and protruded eyeball for 1.5 years in her left eye. After removal of mass, histopathologic examination confirmed neurilemoma.
Adult ; Female ; Humans ; Neurilemmoma ; Orbit* ; Visual Acuity

BACKGROUND: We evaluated the Vitros 950 (Johnson & Johnson Clinical Diagnostics, Inc., NY, USA) in the measurement of digoxin and theophylline levels and compared its results to those of the TDxFLx II (Abbott Laboratories, IL, USA) used for therapeutic drug monitoring (TDM) world-widely in order to assess the utility of the Vitros 950 as a TDM instrument. METHODS: From June 1997 to August 1997, 125 and 135 candidates for TDM were randomly chosen to measure digoxin and theophylline, respectively, using the Vitros 950 and TDxFLx II. The relationship between its results and those of TDxFLx II were determined. The within-run and between-run precisions of the Vitros 950 were determined using two controls (Vitros Performance Verifier I and II; J & J Clinical Diagnostics, Inc., NY, USA). The high-concentration control (Vitros Performance Verifier II) was diluted in Vitros 7% BSA to 5 dilutions. And linearity for quantitative analysis of digoxin and theophylline were determined. RESULTS: The coefficients of variation (CV) for the within-run of the Vitro 950 were 0.8% - 4.4%. And the CV for between-run precision of the Vitro 950 were 1.7% - 12.3%. The linearity of digoxin and theophylline were relatively good. The correlations (r) of digoxin and theophylline levels with those determined by the Abbott TDxFLx II were 0.95 and 0.93, respectively (P <0.001). CONCLUSIONS: The recently developed dry slide method of the Vitros 950 proves to good precision and linearity for quantitative analysis of digoxin and theophylline. Its results correlate well with those of the TDxFLx II. The Vitros 950 does not require an elaborate preparatory protocol for the sample, and is easy to use and maintain.So it is considered a highly feasible instrument for stat test.
Digoxin* ; Drug Monitoring ; Theophylline*

Cryptococcus laurentii is one of several non-neoformans cryptococci that have rarely been associated with human infection. Candida zeylanoides, an unusual Candida species, is also infrequently reported as a human pathogen. We report a case of mixed fungemia with C. laurentii and C. zeylanoides in a 12-year-old girl. The patient with acute myelogenous leukemia was receiving intensive remission induction chemotherapy through a central venous catheter (CVC) and was severely neutropenic. She had been treated with oral fluconazole prophylaxis since admission. C. laurentii and C. zeylanoides were simultaneously isolated from the peripheral blood cultures collected on days 29 and 31 of her hospital stay. The culture of the removed catheter tip grew >15 CFU of both C. laurentii and C. zeylanoides. In vitro susceptibility testing of the strains showed that the MIC of fluconazole for C. laurentii and C. zeylanoides were 8 microgram/mL and 4 microgram/mL, respectively. The patient was successfully treated by CVC removal and by treatment with amphotericin B intravenously. To our knowledge, this represents the first report of C. laurentii and C. zeylanoides fungemia in Korea.
Amphotericin B ; Candida* ; Catheters ; Central Venous Catheters ; Child ; Cryptococcus* ; Drug Therapy ; Female ; Fluconazole ; Fungemia* ; Humans ; Korea ; Length of Stay ; Leukemia, Myeloid, Acute ; Remission Induction

BACKGROUND: Little Is known about the compared efficiency of different third generation enzyme-linked immunosorbent assays (ELISA) fort the detection of anti-HCV. We examine the relative sensitivity and specificity of three third-generation anti-HCV assays, and results of discrepant samples among the anti-HCV ELISA are compared with data of a third-generation recombinant immunoblot assay and reverse transcription polymerase chain reaction (RT-PCR) . METHODS:A total of 167 samples (61 positive and 106 negative), screened by a second-generation IMx(R) anti-HCV assay (Abbott 2.0; Abbott Laboratories, USA), weve tested with Innotest HCV 3.0(R) (Green Cross, Korea), LG HCD 3.0(R) (LG, Korea) and DONG-A HCV 3.0(R) (Dong-4, Korea). The discrepant specimens among the 4 anti-HCV ELISA were tested by LG HCD Confirm(R) (LG, Korea) and RT-PCR. RESULTS: The concordance rates of all 4 ansi-HCV ELISA were 80.2% (134/167) and 92.2% (154/167), respectively. The 28 and 31 of 33 specimens showing discrepancy among 4 anti-HCV ELISA were tested with LG HCD Confirm and RT-PCR, respectively. Serum HCV RNA was positive in 2 of 2 reactive and in 6 of 26 nonreactive on LG HCD Confirm. The sensitivity, specificity, positive predictive value, negative predictive value and concordance rate of 4 anti-HCV ELISA were 97.7%, 85.2%, 70.0%, 99.0% and 88.5% (Abbott 2.0) ; 81.4%, 96.7%, 89.7%, 93.7% and 92 7% (Innotest 3.0), 81.4%, 98.4%, 94.6%, 93.8% and 93.9% (LG 3.0), 86.0%, 95.7%, 88.1%, 95.1% and 93.3% (DONG-A 3.0), respectively. CONCLUSIONS: These data indicate that the sensitivity and specificity of 3 third-generation anti-HCV ELISA are comparable, and that these reagents demonstrate improved specificity compared to the second-generation ELISA.
Enzyme-Linked Immunosorbent Assay* ; Indicators and Reagents ; Polymerase Chain Reaction ; Reverse Transcription ; RNA ; Sensitivity and Specificity

BACKGROUND: BACTEC MGIT 960 system(Becton Dickinson, USA; MGIT 960) is a fully automated, noninvasive culture system for mycobacteria, which has been regarded as a sensitive and least labor-intensive method. This study was purposed to evaluate the performance of MGIT 960 compared to BACTEC 460 TB radiometric system(Becton Dickinson, USA; BACTEC 460) and Ogawa media. METHODS: A total of 1,067 clinical specimens submitted from April to June in 1999 was cultured for acid fast bacilli(AFB). All specimens were digested, decontaminated by the 6% sodium hydroxide(final concentration of 1.5%) and 0.5% N-acetyl-L-cysteine method. All specimens were inoculated into three kinds of media: a MGIT, a BACTEC 12B, and an Ogawa medium. The AFB recovered from cultures were identified to M. tuberculosis complex and MOTT by NAP test. RESULTS: Of 106 isolates of M. tuberculosis recovered from all culture systems, 101(95.3 %) were detected in the MGIT 960, 95(89.6%) in the BACTEC 460 and 76(71.7%) on Ogawa media. MGIT 960 plus Ogawa media detected 104(98.1%) isolates and BACTEC 460 plus Ogawa media recovered 96(90.6%) isolates. The mean time required for detection of M. tuberculosis was 12.7+/-5.8 days with MGIT 960, 16.2+/-7.7 days with BACTEC 460, and 22.8+/-9.5 days with Ogawa media. The contamination rate were 5.1% for MGIT 960, 2.7% for BACTEC 460, and 6.7% for Ogawa media. CONCLUSIONS: MGIT 960 is a sensitive and rapid method to isolate M. tuberculosis.
Acetylcysteine ; Mycobacterium tuberculosis* ; Mycobacterium* ; Sodium ; Tuberculosis

OBJECTIVES: There are much controversy about the duration of antibody persistence, necessity and time of booster for hepatitis B vaccine(HB vaccine). The long term follow-up study is lack in Korea. Therefore this study is designed for evaluating the long-term immunogenicity of HB vaccine, necessity and time of booster vaccination. METHODS: The plasma derived HB vaccine (He-pavax-B(R)) was administered to healthy volunteers (28cases) as usual method. Secondary booster immunization was done at the 2nd year after primary vaccination in 6 cases(anti-HBs<10 mIU/ml). The serum transaminase levels, the HBsAg and anti-HBs were checked at the 9th month, 1st, 2nd, 3rd, 5th and 10th year after primary vaccination. RESULTS: 1) The positivity of anti-HBs (over 10mIU/ml) was 93%, 96%, 92% at the 3rd, 5th, 10th year respectively. In the children under 20 years old, it was 94Yo at the 3rd, 5th and 10th year without the secondary booster. 2) The good responders(anti-HBs>or=100mIU/ml) at the 9th month after primary vaccination are 21 cases (7%), low responders(anti-HBs: 10-100mIU/ml) 5 cases (18%), and non-responders(anti-HBs Adult ; Child ; Follow-Up Studies* ; Healthy Volunteers ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis B Vaccines ; Humans ; Immunization, Secondary ; Korea ; Plasma* ; Vaccination ; Young Adult

Gastric cancer (GC) is one of the most common cancers with high morbidity and mortality. Familial GC is seen in 10% of cases, and approximately 3% of familial GC cases arise owing to hereditary diffuse gastric cancer (HDGC). CDH1, which encodes the protein E-cadherin, is the only gene whose mutations are associated with HDGC. Screening for the familial GC-predisposing gene has been neglected in high-risk countries such as Korea, China, and Japan, where all the cases have been attributed to Helicobacter pylori or other carcinogens. Screening for the GC-causing CDH1 mutation may provide valuable information for genetic counseling, testing, and risk-reduction management for the as-yet unaffected family members. An asymptomatic 44-yr-old Korean male visited our genetic clinic for consultation owing to his family history of GC. Eventually, c.1018A>G in CDH1, a known disease-causing mutation, was found. As of the publication time, the individual is alive without the evidence of GC, and is on surveillance. To our knowledge, this is the first Korean case of presymptomatic detection of CDH1 mutation, and it highlights the importance of genetic screening for individuals with a family history of GC, especially in high-risk geographical areas.
Adult ; Asian Continental Ancestry Group/*genetics ; Cadherins/*genetics ; Exons ; Genetic Counseling ; Genetic Predisposition to Disease ; Genetic Testing ; Germ-Line Mutation ; Heterozygote ; Humans ; Male ; Pedigree ; Republic of Korea ; Sequence Analysis, DNA ; Stomach Neoplasms/*genetics/pathology

BACKGROUND: Peripheral blood stem cell transplantation (PBSCT) has been widely used as a substi-tute of bone marrow transplantation for the treatment of various solid tumors or hematologic malig-nancies. The success of PBSCT is correlated with peripheral blood CD34+ cell count per kilogram of the recipient body weight. Standardization of flow cytometric CD34+ cell enumeration was improved by the modified International Society of Hematotherapy and Gene Engineering (ISHAGE) protocol. The purpose of this study was to evaluate the peripheral parameters (WBCs, mononuclear cells, the CD 34+ cells) that may predict the total CD34+ cell count in the harvest product, using the Stem-Kit (Beck-man Coulter Inc., Fullerton, CA, USA). METHODS: The study tested 88 PBSC harvests and peripheral blood (PB) on the day before collection from 26 patients. The CD34+ cells were analyzed using the Stem-Kit. The WBC and MNC count were measured by Coulter STKS (Beckman Coulter Inc.). The correlation and regression analysis between peripheral parameters (WBCs, MNCs, CD34+ cells) and the total CD34+ cell count in the harvest product were performed. RESULTS: The CD34+ cell count per weight (kg) of 88 PBSC harvests was 1.59 +/- 2.61 (0.01 -17.35). The mean number of WBC, MNC, and CD34+ cell in PB prior to harvest were 10.57 +/- 8.36 (1.50 - 32.50) X 10(3)/micro L, 1.85 +/- 1.28 (0.39- 7.43) X 10(3)/micro L, and 17.21 +/- 33.19 (0.12-239.19)/micro L, respectively. With the CD34+ cells numbering under 3/micro L in peripheral blood (PB), we could not harvest more than 0.5 X 10(6) /kg PBSC. With the cells numbering 3-6/micro L (59%) and 10- 20/micro L (89%), however, we could harvest more than 0.5 X 10(6) /kg and 1.0 X 10(6) /kg, respectively. More than 2.0 X 10(6)/kg of PBSC was collected with 10-20/micro L (31%). The peripheral blood CD34+ cell count prior to harvest significantly correlated with the total CD34+ cell count in the harvest product (r=0.97, P<0.05). CONCLUSIONS: Peripheral blood CD34+ cell enumeration using the Stem-Kit was an efficient predictor of when to harvest peripheral blood stem cells after mobilization therapy. We could not collected the CD34+ cell in harvest product of more than 0.5 X 10(6)/kg if the peripheral blood CD34+ cell count was less than 3/micro L.
Body Weight ; Bone Marrow Transplantation ; Cell Count* ; Humans ; Peripheral Blood Stem Cell Transplantation ; Stem Cells*

BACKGROUND: This study was designed to investigate the isolation rate of Staphylococcus aureus from hands and nasal cavities of physicians and nurses and to determine the relationship between the isolates of S. aureus from patients with nosocomial infection and the isolates from physicians, nurses and the hospital environment. METHODS: Twenty-three S. aureus isolates which consisted of 8 strains from patients, 7 strains from doctors and nurses, 7 strains from hospital environments, and S. aureus ATCC 25923 were examined. Biochemical profile by the use of API Staph (API system, La Balme-Les Grottes, France), antibiogram by disk diffusion method, and random amplified polymorphic DNA analysis (RAPD) were used for the strain differentiation and molecular typing of S. aureus isolates. RESULTS: The isolation rate of S. aureus in hands and nasal cavities of doctors and nurses was 21% (25/ 120) and 28% (33/120), respectively. The isolation frequency of methicillin-resistant S. aureus (MRSA) from doctors, nurses, and hospital environments was 57% (8/ 14). The isolates disclosed 13 different biochemical profiles and 14 different resistant patterns of antimicrobials. All isolates were divided into five molecular types (A~E) by RAPD with a similarity (S) value of 0.55; 10 strains (45%) belonged to type A, 7 (32%) to type C, 3 (14%) to type B, one each to type D and E, respectively. The S value between strain 11 from hospital environments and strain 12 from a patient was 1.00, which means that they are the same on the genetic level. CONCLUSION: These findings reveal the existence of a close relationship between clinical isolates and isolates from hospital environment, including those from physicians and nurses. Thus, the implementation of an infection control programs to reduce the spread of MRSA within hospitals is important for the prevention of nosocomial infections.
Cross Infection ; Diffusion ; DNA ; Hand ; Humans ; Infection Control ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Microbial Sensitivity Tests ; Molecular Epidemiology* ; Molecular Typing ; Nasal Cavity ; Staphylococcus aureus* ; Staphylococcus*