BACKGROUND: Mycobacterial culture is a confirmatory test to detect M.tuberculosis, but it takes at least 6 weeks to diagnose. PCR is a rapid and sensitive method, but it is known that PCR has a high false positive rate due to contamination, and a high false negative rate due to inhibitors. It is also known that LCR and PCR-Hybridization, recently developed methods, are more specific methods than PCR in terms of detection M.tuberculosis. In this study, we estimated the clinical utility of in house PCR, LCR and PCR-Hybridization for the detection of M.tuberculosis. METHODS: We evaluated 75 specimens, upon which M.tuberculosis culture based testing was requested, by PCR LCR, and PCR-Hybridization and compared results. Mycobacterial culture was performed on 3% Ogawa media for 8 weeks, and an in house PCR, LCx Mycobacterium tuberculosis assay kit(Abbott Laboratories, North Chicago, III) and the AMPLICOR M.tuberculosis test kit(Roche Molecular Systems, Inc. Branchburg, NJ, USA). RESULTS: In the view of the culture results, the sensitivities of the three tests were 40%, 80%, and 100% and their specificities were 98.6%, 94.3%, and 94.3%. CONCLUSION: LCR and PCR-Hybridization and rapid and sensitive methods for detecting M.tuberculosis in clinical laboratories.
Mycobacterium tuberculosis ; Polymerase Chain Reaction* ; Tuberculosis*

This study was conducted to compare the maternal characteristics, and birth weight of infants delivered at five different categories of medical facility in Taegu to examine the risk level of pregnant women and children by the medical facility for delivery. The study population included 1,410 pregnant women who delivered a baby at one of nine medical facilities (3 university hospitals, 2 general hospitals, 2 private clinics, 1 midwife clinic, 1 MCH center) in Taegu in April, 1987(April and May, 1987 for K university hospital). Pregnant women were interviewed to ask the age and educational level of woman, payment of medical fee, birth order, delivery method. Birth weight of infant was obtained from medical record. Mean ages of the women delivering at the university hospitals(27.5 years) and at general hospitals(26.7 years) were higher than those at midwife clinic(25.4 years) and at MCH center(26.1 years). Also, mean years of school education were higher in women of university hospitals(12.7 years) and general hospitals(12.2 years) than in women of midwife clinic(9.2 years) and MCH center (9.3 years). The percentages of women covered by the medical insurance were far greater in the university hospitals(78.1%) and general hospitals(82.9%) than in private clinics(44.3%), midwife clinic(29.1%) and MCH center (5.4%). Infants born at the MCH center were mostly the second birth (47.3%) while 56.0% to 61.7% of infants born at all the other medical facilities were the first birth more women delivering at the university hospitals had history of spontaneous abortion as well as still birth than the women delivering at the other medical facilities. The preterm birth rate (11.4%) and low birthweight incidence rates(5.8-13.0%) in university hospitals were significantly higher than those of other medical facilities. Accordingly, c-section rates showed a wide variation among the medical facilities. Study findings revealed that most of women delivering at the university hospitals and general hospitals are in the middle of or upper socio-economic class and obstetrically high risk group regardless of socioeconomic class while the women delivering at the midwife clinic and MCH center are low risk group of low socioeconomic class. Therefore, the data of a specific medical facility are highly limited in interpretation and can not be generalized.
Abortion, Spontaneous ; Birth Order ; Birth Weight* ; Child ; Daegu* ; Education ; Fees, Medical ; Female ; Hospitals, General ; Hospitals, University ; Humans ; Incidence ; Infant ; Insurance ; Medical Records ; Midwifery ; Parturition* ; Pregnancy ; Pregnant Women ; Premature Birth

Holoprosencephaly(HPE), a common developmental defect affecting the forebrain and cranioface, is etiologically heterogenous. Teratogen, chromosomal anomalies, genetic syndrome, or genetic disorder of non-syndromic HPE are usually accepted as etiology. But the severity of brain and craniofacial malformation are not associated with etiology. Individuals with microform of HPE, who usually have normal cognition and brain imaging, are at the risk of having children with HPE. Several studies on the basis of HPE gene have been performed, which shed valuable insight on normal brain development. As additional HPE genes are identified, more accurate recurrent risk counseling can be given. We experienced a case of recurrent HPE diagnosed by transabdominal ultrasound examinations at 22 weeks' gestation.
Brain ; Child ; Cognition ; Counseling ; Holoprosencephaly* ; Humans ; Microfilming ; Neuroimaging ; Pregnancy ; Prosencephalon ; Ultrasonography

Corticosteroid, 5-fluorouracil and Mitomycin C(MMC) have been used to suppress proliferation of subconjunctival connective tissue. However, the various complication and undesirable side effects associated with the use of these drugs have prompted the search for alternative drugs with less toxicity. In present study, I have evaluated the effect of corticosteroid(dexamethsone sodium phophate), cyclooxygenase inhibitor(diclofenac sodium) and lipoxygenase inhibitor(nordihydroguaratic acid, NDGA) to inhibit human pterygial fibroblast proliferation in tissue culture. Human pterygial fibroblast were cultured and exposed to various concentration of each drug for 1, 2 and 3 days. Cell viability was measured using MTT assay. There was no different in antiproliferative activity between nonsteroidal antiinflammatory agents(NSAIDs) and steroid. Dexamethasone caused inhibition of proliferation with LD 50 of 0.5mM by day 2, NDGA of 0.5mM by day 3 and diclofenac sodium of 1.0mM by day 3. These results suggest that NSAIDs may be useful as both antiproliferative and less toxicity agents.
Anti-Inflammatory Agents, Non-Steroidal* ; Cell Survival ; Connective Tissue ; Dexamethasone ; Diclofenac ; Fibroblasts* ; Fluorouracil ; Humans* ; Lipoxygenase ; Mitomycin ; Prostaglandin-Endoperoxide Synthases ; Sodium ; Steroids*

PURPOSE: To evaluate the relationship between intraocular pressure (IOP) and cardiovascular risk variables in healthy Koreans adjusted for age and mean blood pressure. METHODS: A total of 1477 healthy participants underwent automated multi-phasic test, including tonometry, automated perimetry, fundus photography, blood pressure, and cardiovascular risk variables such as total cholesterol, high density lipoprotein, triglyceride, and blood glucose. The subjects were divided into six age groups by decades ranging from 20~29 years to over 70 years. The relationship between IOP and cardiovascular risk variables was examined using multiple regression analysis. RESULTS: The mean age of participants was 49.0 years, and 778 (52.7%) of participants were men. The mean IOP was 15.8+/-3.2 mmHg, and was significantly higher in men than in women (p<0.05). The prevalence of ocular hypertension was 5.9% in men and 3.1% in women. IOP was associated with mean blood pressure, gender, age, total cholesterol, triglyceride, and blood glucose (p<0.05). The relationship between IOP and age adjusted for mean blood pressure and cardiovascular risk variables showed a significantly negative tendency (p<0.05). Total cholesterol, triglyceride, and blood glucose values after adjusting for age and mean blood pressure had a significantly positive relation with IOP (p<0.05), but there was no significant relation between IOP and high density lipoprotein (p>0.05). CONCLUSIONS: As increased IOP was associated with cardiovascular risk variables, it is necessary to control increased total cholesterol, triglyceride, and blood glucose levels in the normal population to prevent or control the IOP elevation.
Blood Glucose ; Blood Pressure ; Cholesterol ; Female ; Humans ; Intraocular Pressure* ; Lipoproteins ; Male ; Manometry ; Ocular Hypertension ; Photography ; Prevalence ; Risk Factors* ; Triglycerides ; Visual Field Tests

No abstract available.
Diskectomy*

A 50-year-old female was referred to our clinic with visual disturbance, hyphema and increased intraocular pressure (IOP) in her right eye 7 days after experiencing blunt trauma in that eye. She had undergone uncomplicated laser in situ keratomileusis (LASIK) on both eyes 10 years earlier. At initial examination, the best corrected visual acuity (BCVA) in her right eye was counting fingers at 2 feet with no correction. Central Goldmann applanation tonometry (GAT) showed an IOP of 7 mm Hg. Peripheral digital tonometry showed the IOPs in her right eye superiorly, nasally, temporally, and inferiorly were 36 mm Hg, 35 mm Hg, 34.5 mm Hg and 36.5 mm Hg, respectively. Slit-lamp examination showed diffuse epithelial and stromal edema and a blood clot 1 mm in height in the anterior chamber. Spectral domain scanning laser ophthalmoscope/optical coherence tomography (SD-SLO/OCT) images showed a pocket of fluid between the LASIK flap and the underlying stroma. The patient was started on anti-inflammatory agent and IOP lowering agents. After 15 days of treatment, IOP measured with GAT was 10 mm Hg, slit-lamp examination showed that epithelial and stromal edema had disappeared, and OCT showed no fluid between the corneal flap and stroma.
Anterior Chamber ; Edema ; Female ; Fingers ; Foot ; Humans ; Hyphema* ; Intraocular Pressure ; Keratomileusis, Laser In Situ* ; Manometry ; Middle Aged ; Visual Acuity

Biliary cystadenoma is a rare biliary ductal neoplasm that usually arises in the liver and less frequently in the extrahepatic bile ducts. Clinical manifestations are non-specific; hence preoperative diagnosis depends heavily on imaging. Computed tomography, ultrasonography, angiography and cholangiogram are useful diagnostic procedures in biliary cystic tumor, but definite diagnosis depends on histologic diagnosis. Surgical resection often yields excellent results. Surgical procedures used to treat cystadenomas include: aspiration, drainage, marsupialization, and excision. If there is no evidence of metastasis, complete resection of these tumors is necessary for a complete cure. We experienced an 80-year-old man who complained of jaundice and RUQ pain. He was diagnosed as biliary mucinous cystadenoma, We confirmed our diagnosis by cholangioscopic biopsy, and performed endoscopic sphincterotomy(EST). So, we report this case and have reviewed the relevant literature as a part of our report for the subject case.
Aged, 80 and over ; Angiography ; Bile Ducts, Extrahepatic ; Biliary Tract* ; Biopsy ; Cystadenoma ; Cystadenoma, Mucinous* ; Diagnosis ; Drainage ; Humans ; Jaundice* ; Liver ; Mucins* ; Neoplasm Metastasis ; Pancreas* ; Ultrasonography

BACKGROUND: A Nerve ligation injury may produce a pain syndrome that includes tactile allodynia. Reversal effects on tactile allodynia have been demonstrated after an intrathecal administration of adenosine analogues or morphine. Adenosine receptor agonists have been known to have antinociceptive and antiallodynic effects in many animal and human studies. We examined the drug interactions between morphine and adenosine agonists in a rat model of a nerve ligation injury. METHODS: Male Sprague Dawley rats were prepared with a tight ligation of the left lumbar 5 th and 6 th spinal nerves and chronic lumbar intrathecal catheter implantation for drug administration. We measured the tactile allodynia by applying von Frey filaments ipsilateral to the lesioned hindpaw. Thresholds for paw withdrawal were assessed. Morphine (1 - 30ng), adenosine (1 - 30ng) and R-PIA (0.1 - 10ng) were administered to obtain the dose-response curves and the 50% effective dose (ED50). Fractions of ED50 values were administered to establish the ED50 of drug combinations. Drug interactions were evaluated by the fractional and isobolographic analyses. Allodynic thresholds for left lesioned hindpaw withdrawal to the von Frey hairs test were assessed and converted to % maximal possible effect (%MPE). RESULTS: The antiallodynic effect of morphine, adenosine, and R-PIA were produced in a dose dependent manner. The antiallodynic effects of combinations showed a similar pattern. Isobolographic analysis revealed a synergistic interaction for the morphine-R-PIA combination but not for the morphine-adenosine combination. However, fractional analysis produced a synergistic result for two combination groups. CONCLUSIONS: The results demonstrated that intrathecal co-administration of adenosine A1 receptors agonist and morphine showed the synergistic effect on nerve ligation injury induced allodynia.
Adenosine* ; Animals ; Catheters ; Drug Combinations ; Drug Interactions ; Hair ; Humans ; Hyperalgesia ; Injections, Spinal ; Ligation* ; Male ; Models, Animal ; Morphine* ; Purinergic P1 Receptor Agonists* ; Rats* ; Rats, Sprague-Dawley ; Receptor, Adenosine A1 ; Receptors, Purinergic P1* ; Spinal Nerves

Ankylosing spondylitis(AS) and diffuse idiopathic skeletal hyperostosis(DISH) increase the risk of spinal fracture after minor trauma in an ankylosed spine. There are few reports on a spinal fracture in people with both conditions. A 67-year-old man visited our emergency room with moderate back pain developed after slipping. No neurological deficit was noted. On physical examination, direct tenderness was noted in the back at the level of the thoracolumbar(TL) junction. Radiological evaluations showed the compression fracture of ankylosed spine and the coexistence of AS and DISH. Vertebroplasty was performed in fractured spine due to persistent back pain. Several weeks later, neurological deficits were developed. Finally, decompressive laminectomy and posterior screw fixations were performed. After operation, neurological deficits were fully recovered and patient was discharged. Patient who had a fracture of an ankylosed spine in association with coexisting AS and DISH could be considered the early surgical treatment.
Aged ; Back Pain ; Emergencies ; Fractures, Compression ; Humans ; Hyperostosis, Diffuse Idiopathic Skeletal ; Laminectomy ; Physical Examination ; Spinal Fractures ; Spine ; Spondylitis, Ankylosing ; Vertebroplasty