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*

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

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

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

BACKGROUND: Human cytomegalovirus (CMV) infections are common and occasionally severe in newborns, immunocompromised hosts, cancer patients, and recipients of organ transplant. Consequently, sensitive and rapid methods for CMV detection are of great diagnostic value since antiviral drugs have become available, which might be more effective upon early administration. We evaluated a polymerase chain reaction and enzyme-linked immunosorbent assay (PCR- ELISA) to detect human CMV infection as an aid in making a prompt diagnosis and a determination of therapeutic efficacy. METHODS: CMV DNA was amplified by single PCR, using primers chosen from genomic regions (major immediate-early [MIE] protein coding region), and the microwell plate hybridization assay was performed for specific detection of 5'-biotinylated PCR products using CMV-specific probes labeled with digoxigenin. A total of 35 clinical specimens from 14 patients who were suspected CMV infectious state was analyzed by PCR-ELISA and its results were compared with those of serum anti-CMV IgM, shell vial culture assay and PCR. RESULTS: The sensitivity for detection of PCR-amplified CMV DNA by the ELISA was 102 copies, which was ten-fold greater than ethidium bromide staining of agarose gels. The positive rates of 35 clinical specimens by serology, shell vial culture assay, PCR and PCR-ELISA were 37.9%, 40.0%, 60.0% and 68.6%, respectively. The OD ranges of 24 positive specimens by PCR-ELISA were from 0.042 to above 2.5. In follow-up studies of two patients with bone marrow transplantation, positive CMV results by PCR-ELISA earlier than by other methods including serologic method, shell vial culture assay and PCR. CONCLUSIONS: These results reveal that PCR-ELISA may show higher sensitivity and positive rate than serologic method, shell vial culture assay and conventional PCR. PCR-ELISA can be useful to manage CMV infection rapidly in patients at risk.
Antiviral Agents ; Bone Marrow Transplantation ; Clinical Coding ; Cytomegalovirus* ; Diagnosis ; Digoxigenin ; DNA* ; Enzyme-Linked Immunosorbent Assay ; Ethidium ; Follow-Up Studies ; Gels ; Humans* ; Immunocompromised Host ; Immunoglobulin M ; Infant, Newborn ; Polymerase Chain Reaction ; Sepharose ; Transplants

BACKGROUND: Despite the recognized increase of frequency of candiduria due to Candida tropicalis, little was known of its molecular epidemiology. We applied PFGE and RAPD assay for urinary C. tropicalis isolates and evaluated the utilities of PFGE and RAPD for the epidemiological typing of C. tropicalis isolates. METHODS: A total of urinary 57 isolates of C. tropicalis from 40 patients at two hospitals was analyzed. PFGE analysis were performed by electrophoretic karyotyping (EK) and restriction endonuclease analysis of genomic DNA (REAG) using two restriction enzymes (BssHII and SfiI). For RAPD, a total of 31 primers (30 random 10-mer primers and M13 primer) were used. RESULTS: EK and RAPD analysis showed the same or similar patterns among the isolates. REAG with BssHII separated 57 isolates into 28 distinct types. Six patterns were generated by REAG with using SfiI. By combining the two REAG, a total of 31 different DNA types were identified among 57 isolates from 40 patients. Three strain types were common to 23 isolates from 12 patients of a University Hospital, which suggested possible nosocomial transmission. In 19 patients with serial urinary isolates, the sequential strains from each patient exhibited the same REAG pattern. CONCLUSION: These suggest that REAG with BssHII and SfiI is useful for the investigation of molecular epidemiology of C. tropicalis isolates. In addition, some clusters of C. tropicalis isolates with the same DNA type suggest that nosocomial transmission may occur.
Candida tropicalis* ; Candida* ; DNA Restriction Enzymes ; DNA* ; Electrophoresis, Gel, Pulsed-Field* ; Humans ; Karyotyping ; Molecular Epidemiology ; Molecular Typing*

BACKGROUND: Optimal use of tricyclic antidepressants (TCAs) requires serum monitoring to determine if the appropriate therapeutic range has been attained and to assess possible side effects. This study was to evaluate the resolution capacity of the following four mobile phases which were previously reported; mobile phase I (methanol, acetonitrile and 5 mmol/L Na2HPO4: 41/15/44 by volume), II (methanol, acetonitrile and 5 mmol/L Na2HPO4,: 15/60/25 by volume), III (acetonitrile and 2-propanol: 95/5 by volume) and IV (methanol and n-butylamine: 99.5/0.5 by volume). METHODS: Amitriptyline (AT), nortriptyline (NT), imipramine (IMI) and doxepin (DOX) were used for the selection of appropriate mobile phase in high performance liquid chromatographic (HPLC) determination. TCAs were extracted from serum with hexane, isoamyl alcohol (99:1). The drug was re-extracted into 0.1 N HCl and an aliquot was injected into the HPLC. The analytical column was C-18 reversed phase column (3.9 mm x 30 cm; Waters, USA) with the flow rate of 1.5 mL/min. The UV detector signal was monitored at 254 nm. RESULTS: Mobile phase I disclosed 9.8-15.8 retention time (min), 5.1-8.8 capacity ratio and 1.0-2.2 resolution factors for the above four TCAs. Precision studies using this mobile phase demonstrated a coefficient variation of 2.4-4.7% in the concentration range of 500-125 ng/mL. Analytical recovery of AT and IMI was 85-90% at a concentration of 125 ng/mL and 250 ng/mL. CONCLUSIONS: Mobile phase I provided a reliable and excellent resolution of TCAs in the use of HPLC with the C-18 reversed phase column and UV absorbance detector.
2-Propanol ; Amitriptyline ; Antidepressive Agents, Tricyclic* ; Chromatography, High Pressure Liquid ; Doxepin ; Imipramine ; Nortriptyline