The diagnostic value of the DNA polymerase chain reaction for the detection of M. tuberculosis in tuberculous meningitis uas established by using cerebrospinal fluids obtained from 7 bacteriologically confirmed patients (Group IA), 17 clinically diagnosed patients (Group IB), 21 patients with other bacterial or viral meningitis (Group IIA) and two norrnal persons (Group IIB) The PCR was perforrned with P1 and P2 primer set which directed against the 123bp segment of IS5110. A repetitive sequence of M. tuberculosis chromosome. The sensitivity and specificity of the PCR for the detection of M. tuberculosis was evaluated by using DNAs purified from cultured M tuberculosis and M intracellulare . The detection limit by the PCR amplication with Pl and P2 primer was lfg of DNA for M. tuberculosis and lpg for M. intracellulare indicating that the PCR was very sensitive for M. tubererculosis DNA detection; although weakly cross-reactive with DNA of M. tuberculosis. Of the 7 cerebrospinnal fluids from bacterologically proven tuberculous meningitis patients (Group IA), 7 samples were all positive by PCR (10Q%). 15 sarnples of 17 the AFB smear-negative and culture-negative samples from tuberculous meningitis patients (Group IB) were positive by PCR (88.2%) and 2 of 2l sanples from other meningitis patients (Group IIA) showed positive reaction (9.5%). There were no sarnples whick showed positive reaction by PCR among 2 sarnples from normal persons (Group IIB). This results indicated that the PCR using P1 and P2 primer set was useful for the early diagosis of tuberculous meningitis.
Cerebrospinal Fluid ; DNA ; Humans ; Limit of Detection ; Meningitis ; Meningitis, Viral ; Penicillin G Benzathine ; Polymerase Chain Reaction* ; Repetitive Sequences, Nucleic Acid ; Sensitivity and Specificity* ; Tuberculosis ; Tuberculosis, Meningeal*

Astigmatic change in planned extracapsular cataract extraction (P-ECCE) using temporal scleral incision (n=25 eyes) was compared for 2 months with that using superior scleral incision(n=19 eyes), retrospectively. The astigmatic change was analyzed using Naeser`s polar value. Surgically induced astigmatism induced by temporal scleral incision was 0.96+/-1.38D of with the rule(WTR), 2.35+/-1.36D (WTR), and 2.45+/-1.24(WTR) at 3 days, 2 weeks, and 2 months, respectively. In contrast, that induced by superior scleral incision was 2.29+/-2.30D(WTR), 0.76+/-2.39(WTR)and -0.95+/-1.88D of against the rule(ATR) at 3 days, 2 weeks, and 2 months, respectively. In another words, temporal scleral incision in P-ECCE induced WTR astigmatism as early as postoperative 3 days that incerased by 2 weeks and stabilized after 2 weeks, whereas superior scleral incision in P-ECCE induced a prominent WTR astigmatism as early as postoperative 3 days, that was converted to ATR astigmatism from 1 month and increased the change by 2 months. With this result, it was found that most cataract patients existing ATR astigmatism would be candidates for temporal incision in P-ECCE.
Astigmatism* ; Cataract Extraction* ; Cataract* ; Humans ; Retrospective Studies

In order to investigate the clinical results of clear lens extraction for high myopia, the effects of 5.5mm sutureless corneoscleral procedure with low power IOL insertion on 21 patients (31 eyes) who were followed up averagely for 9.43 months were analyzed retrospectively. Prophylactic retinal treatment with argon laser was performed in 23 eyes to prevent retinal detachment. Eighty-seven percent (25/31 eyes) of eyes were within +/-1D of targeted refractive error and all eyes were within +/-2D of targeted refractive error. The postoperative corrected visual acuities were increased in 96.8% (30/31 eyes) and 80.7% (25/31 eyes) among them gained two or more lines. the corrected visual acuity of 20/40 or better were increased from 35.5%(11/31 eyes) preoperatively to 93.6% (29/31 eyes) postoperatively. Posterior capsular opacification was developed in two eyes and YAG laser posterior capsulotomy was performed at 2 and 7 months postoperatively. No retinal break, no cystoid macular edema were developed during the follow up period. In conclusion, the clear lens extraction was effective method for correction of severe high myopia but longer follow-up is needed to evaluate it`s complications.
Argon ; Follow-Up Studies ; Humans ; Lasers, Solid-State ; Macular Edema ; Myopia* ; Posterior Capsulotomy ; Refractive Errors ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde ; Retrospective Studies ; Visual Acuity

Apolipoprotein E-epsilon4(APOE4) is recently known as a susceptibility gene or risk factor associated with late-onset Alzheimer's disease (AD). Association between APOE4 and probable AD was determined in Korean population. Twenty patients met the NINCDS-ADRDA probable AD criteria (M:F=7:13, Mean age: 70.1 yr)were compared with 146 controls without dementia (M:F=83:63, Mean age:63.6 yr). APOE genotype was determined by polymerase chain reaction and allele specific hybridization technique. APOE4 allele frequency (0.33 vs. 0.11, p<.01) and proportion of carriers with APOE4(60% vs. 19%, p<.01) were significantly increased in patient group. APOE4 genotype is also associated with late-onset sporadic AD in Korean, and APOE genotyping may be useful for differential diagnosis of AD for patients with dementia.
Alleles ; Alzheimer Disease* ; Apolipoprotein E4 ; Apolipoproteins E ; Apolipoproteins* ; Dementia ; Diagnosis, Differential ; Gene Frequency ; Genotype* ; Humans ; Korea* ; Polymerase Chain Reaction ; Risk Factors

Background & Objective: The MAPT H1 haplotype and SNCA single nucleotide polymorphism (SNP) rs356219 have been reported to have a synergistic effect on the risk of Parkinson’s disease (PD). Because the H1/H1 genotype has been reported to predominate in Korean population, we investigated the polymorphism of rs356219 in 878 PD patients and 559 controls. Methods: The SNCA SNP rs356219 was analyzed in 878 PD patients and in 559 healthy Korean subjects. Results: The G allele of SNCA SNP rs356219 was found to contribute to PD susceptibility with odds ratios (ORs) similar to those reported previously. However, the ORs were not as large as that of the SNCA rs356219 plus MAPT H1/H1 combination reported in the literature, which cast doubt on the existence of a synergistic effect between the two genotypes in our population. Conclusions: This study supports that the G allele of the SNCA SNP rs356219 contributes to PD susceptibility as reported previously, but it does not support the presence of a synergistic interaction between SNCA and MAPT.

We present a case of metastatic mailgnant melanoma developed in the 40 year- old male patient. Six month prior to visit to our department of dermatology, the patient found an egg sized mass covered with normal skin on his right inguinal area, which showed typical findings of the metastatic malignant melanoma histopathologically. The primary malignant melanoma on the right shin was removed by wide surgical excision at 18 months prior to visit to our department of dermatology.
Dermatology ; Humans ; Male ; Melanoma* ; Ovum ; Skin

The efficacy of endovascular treatment (EVT) in patients with posterior circulation stroke has not been proven. Two recent randomized controlled trials failed to show improved functional outcomes after EVT for posterior circulation stroke (PC-EVT). However, promising results for two additional randomized controlled trials have also been presented at a recent conference. Studies have shown that patients undergoing PC-EVT had a higher rate of futile recanalization than those undergoing EVT for anterior circulation stroke. These findings call for further identification of prognostic factors beyond recanalization. The significance of baseline clinical severity, infarct volume, collaterals, time metrics, core-penumbra mismatch, and methods to accurately measure these parameters are discussed. Furthermore, their interplay on EVT outcomes and the potential to individualize patient selection for PC-EVT are reviewed. We also discuss technical considerations for improving the treatment efficacy of PC-EVT.

beta-amyloid peptide (Abeta) consisting of 40 to 42 amino acid is the principle constituent of senile plaques in Alzheimer's disease. Although, the hypothesis that deposition of AP triggers a cascade of events leading to the pathology of Alzheimer's disease has been widely accepted, direct evidence for triggering accumulation of phosphorylated tau in paired helical filament is rare. In this study, we examined neurotoxicity induced by 3 kinds of beta-amyloid peptides 1 ~28, 25~,35 and 1~40 to elucidate the way of mechanism trading to neuronal cell death caused by Abeta using cultured hippocampal neurons. For this purpose, we measured lactate dehydrogenase (LDH) in the culture media after treatment with Abeta combined with anti-oxidant drug, trolox, or not. By histochemical and TUNEL method, we studied the change of immunoreaction to anti-MAP-2 (microtubule associated protein -2, the main component of neuritis) and detected apoptotic cells, respectively, in the hippocampal neurons treated with Abeta. To investigate whether tau phosphorylation involve neurotoxicity induced by Abeta, we immunostained the neurons with anti-SMI-31 to recognize phosphorylated Ser 396/404 of tau. From our data, we suggested that Abeta1-40 and Abeta25-35 induced marked neurodegenerative changes, and the mechanism responsible for cell death caused by Abeta -neurotoxicity was associated with the apoptosis. Because Abeta-neurotoxicity was not inhibited by anti-oxidant, trolox, we suggested that anti-oxidant did not protect the neuronal cells against the damage induced by Abeta in ou. expo.imental envi.onment. Finally, we suggested that AP treatment did not potentiate the immunoreactivity to anti-phosphorylated tau antibody and we speculated that Abeta-neurotoxicity led hippocampal cells to apoptosis without tau phosphorylation.
Alzheimer Disease ; Apoptosis* ; Cell Death ; Culture Media ; In Situ Nick-End Labeling ; L-Lactate Dehydrogenase ; Neurons* ; Pathology ; Peptides* ; Phosphorylation* ; Plaque, Amyloid

When neurologic clinical manifestation suggests encephalitis but inflammation of brain has not occurred, the condition is identified by the less specific term encephalopathy. A strange type of acute encephalopathy, which is characterized by symmetrical low density areas in both thalami on brain computed tomography (CT) images, has been reported in Japan and Taiwan. This type of acute encephalopathy usually occurs in infants and young children without sexual predilection and is preceded by fever and symptoms of upper respiratory infection for several days. These symptoms are followed by the rapid evolution of stupor and coma, associated with generalized seizures and decorticated and decerebrated rigidity without focal neurologic or meningeal signs. Brain CT images demonstrates symmetrical low density areas in both thalami. Because it is preceded by fever and symptoms of upper respiratory infection and pathologic finding shows necrosis, petechiae, and marked congestion of the veins and capillaries suggesting noninflammatory vascular changes, it may be a postviral or postinfectious brain disorder, characterized by the distribution of the lesions. We experienced two cases of this type of acute encephalopathy in siblings, who showed symmetrical low density areas in both thalami on brain CT images and report these cases with a brief review of related literatures.
Brain ; Brain Diseases ; Capillaries ; Child ; Coma ; Encephalitis ; Estrogens, Conjugated (USP) ; Fever ; Humans ; Infant ; Inflammation ; Japan ; Necrosis ; Purpura ; Seizures ; Siblings* ; Stupor ; Taiwan ; Thalamus ; Veins

To evaluate the result of diathermic capsulotomy for phacoemulsification in hypermature intumescent cataracts, we retrospectively studied 34 patients(35 eyes) who were operated from January 1995 to February 1997. Central corneal endothelia cell counts were taken preoperatively and 2 months postoperatively by non-contact specular microscopy and endothelial cell loss(%) was calculated. The anterior capsular radial tear occurred in 24 eyes(68%), posterior capsular rupture occurred in 1 eye(2.9%) and the percentage of postoperative endothelial cell loss was 6.45(+/-7.27)%. The high rate of anterior capsular radialtear was due to altered mechanical integrity of the diathermic capsulotomy edge. But the thermal effect on the corneal endothelium was minute. Based on these findings, the diathermic capsulotomy for phacoemulsification in hypermature intumescent cataracts is very useful technique.
Cataract* ; Cell Count ; Endothelial Cells ; Endothelium, Corneal ; Microscopy ; Phacoemulsification* ; Retrospective Studies ; Rupture