BACKGROUND: The diagnosis of tuberculosis has been based on the detection of tubercle bacilli by acid-fast stain of smear or cultures, and recently the serologic diagnosis of tuberculosis has been provided a means of sensitive and specific detection of Mycobacterium tuberculosis. We evaluated the utility of enzyme immunoassay using determiner Tuberculosis Glicolipids(TBGL) antibody kit(Kyowa Medex Co. Ltd, Japan) to detect anti-TBGL antibody for diagnosis of pulmonary tuberculosis. METHODS: Anti-TBGL antibody assay was performed to the form 44 patients with active pulmonary tuberculosis(17 patients with smear positive, 7 patients with only culture positive, 20 patients with clinically active tuberculosis) and 80 controls (30 healthy controls, 24 patients with non-tuberculous respiratory diseases, 26 patients with inactive tuberculosis). We compared the sensitivity and specificity of anti-TBGL antibody with culture and AFB stain. RESULTS: Anti-TBGL antibodies were detected in 16 of 17(94%) smear positive patients, 4 of 7 patients with only culture positive and 16 of 20(80%) smear negative patients who had been clinically diagnosed as active pulmonary tuberculosis. Nine(35%) out of 26 patients with inactive tuberculosis, one(4%) out of 24 patients with non-tuberculous respiratory diseases and no one of healthy control had a positive antibody response. Overall sensitivity, specificity of the anti-TBGL antibody assay were 82%, 88%, respectively and sensitivities and specificities of culture and AFB smear 64%, 97%, and 49%, 100%, respectively. Anti-TBGL antibody titers in patients with active tuberculosis were significantly higher than control grup(P<0.05). Conclusions : The anti-TBGL antibody assay was sensitive, rapid and convenient. This assay will be useful as a tool for the diagnosis of tuberculosis in combination with other conventional methods.
Antibodies ; Antibody Formation ; Diagnosis* ; Humans ; Immunoenzyme Techniques* ; Mycobacterium tuberculosis ; Sensitivity and Specificity ; Tuberculosis ; Tuberculosis, Pulmonary*

No abstract available.
Iron*

BACKGROUND: The purpose of this study is to evaluate the evidence for the effectiveness of different isolation policies in reducing the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection in hospital in-patients. METHODS: We prospectively evaluated the effectiveness of an isolation policy on transmission of MRSA in the 745-beds hospital. First period, all patients with MRSA (March - July 2000) were not isolated Second period, strict isolation policies were performed (August 2000 - January 2002). All patients with MRSA were isolated in separated room, hand hygiene using alcohol handrub, gowning and g1oving, apply of MRSA notice sticker, criteria in isolation remove, separated disinfection and wastement. Third period, semi strict isolation policies were performed (February 2002 - August 2005). Some patients with MRSA were isolated in separated room and others were admitted in general ward for bed shortage. Only some practices were performed in hand washing and separated disinfection in general ward. RESULTS: The rates of MRSA nosocomial infection per patients during 1st, 2nd, and 3rd surveillance were reported 0.56, 0.23, and 0.42 (P<0.05). Patient-days rate of MRSA nosocomial infection during 1st, 2nd, and 3rd surveillance were reported 0.62, 0.27, and 0.38 (P<0.05). CONCLUSION: With many different isolation policies, it was possible to reduce nosocomial infection of MRSA. In this study, strict isolation policies (2nd period) were the most effective practices in reducing MRSA infection.
Cross Infection ; Disinfection ; Hand Disinfection ; Hand Hygiene ; Humans ; Incidence ; Infection Control ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Patients' Rooms ; Prospective Studies

BACKGROUND: The triple marker test with maternal serum during 15-20 weeks gestation, based on AFP, hCG and uE3, is a useful screening technique for detecting chromosomal abnormalities and neural tube defect (NTD). However, the false positive rate has been reported from 4 to 8%. The purpose of this study was to evaluate whether or not women with a false positive result of the triple marker screening are at an increased risk for adverse outcomes other than chromosomal abnor-malities and NTD. METHODS: The study population was derived from 5,622 women undergoing triple marker screening at Mokdong Hospital between January, 1997 and August, 1999. A false positive was defined as a positive result of the triple marker test without further evidence of NTD or chromoso-mal abnormalities. The study group included 83 women whose results were a false positive and the 129 controls whose results were negative. The adverse outcomes included preterm delivery (<37 weeks), premature rupture of the membrane, pre-eclampsia, a low weight for the particular gesta-tion age (<10 percentile), a congenital anomaly and fetal death. RESULTS: The false positive rate of the triple marker test was approximately 1.5%. The overall inci-dence of adverse outcomes in the women with false positive result and those with a negative result were similar (30.1% vs 30.2%, respectively) (P > 0.05). However, adverse outcomes such as pla-cental abnormalities (8.4% vs 2.3%) and congenital anomalies (7.2% vs 0.8%) were more frequent in the women with a false positive result than women with a negative result s (P < 0.05). CONCLUSIONS: The results suggest that false positive results of the triple marker screening test do not appear to be associated with an increased risk for an adverse pregnancy outcome, but a careful evaluation for the placental and fetal abnormalities is necessary.
Chromosome Aberrations ; Female ; Fetal Death ; Humans ; Mass Screening* ; Membranes ; Neural Tube Defects ; Pre-Eclampsia ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Rupture

OBJECTIVE: This study examined the overall mental health consequences of the bereaved parents after the Sewol ferry accident. METHODS: Eighty-four bereaved parents participated in the study. Self-report scales assessing the severity of psychiatric symptoms and other related psychosomatic problems were used at 18 months following the accident. Univariate descriptive statistics and regression analyses were performed to report the prevalence, severity, and correlates of psychiatric symptoms. RESULTS: 94% of the participants appeared to suffer from complicated grief based on scores on the Inventory of Complicated Grief (ICG). Half of the participants were categorized as having severe depression and 70.2% reported clinically significant post-traumatic symptoms according to scores on the Patient Health Questionnaire-9 (PHQ-9) and PTSD Check List-5 (PCL-5). No significant differences by gender were observed in the severity of psychiatric symptoms. A higher educational level was associated with more severe psychiatric symptoms in fathers. CONCLUSION: The loss of a child due to a disaster caused by human error may continue to have a substantial impact on parental mental health at 18 months after the event. A longitudinal study following parents' mental health state would be necessary to investigate the long-term effects of the traumatic experience in the future.
Bereavement* ; Child ; Depression ; Disasters ; Fathers ; Grief ; Humans ; Longitudinal Studies ; Mental Health* ; Parents* ; Prevalence ; Stress Disorders, Post-Traumatic ; Weights and Measures

A CD7 positive acute leukemia, lacking CD4, CD8, CD3, CD13 and CD33 expression may include 4 categories; acute T-cell leukemia, mixed lineage leukemia, acute undifferentiated leukemia and CD7 positive acute myeloid leukemia. Therefore, the expression of cyCD3 or the presence of TCR gene rearrangement can make the diagnosis of acute T-cell leukemia. We report a patient with acute T-cell lymphoblastic leukemia, showing CD7+, CD4-CD8-, and CD3-expression and TCR gamma gene rearrangement.
Diagnosis ; Genes, T-Cell Receptor ; Genes, T-Cell Receptor gamma ; Humans ; Leukemia ; Leukemia, Myeloid, Acute ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma ; T-Lymphocytes

Clear cell carcinoma of the ovary is a clinicopathologic entity with distinct morphologic characteristics and known to be associated with poor prognosis irrespective of stage and prognostic benefits of chemotherapy have not been evidently demonstrated. This represents 2-3.6% of all ovarian malignancies. From October, 1991 to January, 1998, nine patients with primary clear cell carcinoma of the ovary treated in the deptartment of Gynecology and Obstetrics, University of Ulsan, Asan Medical Center were identified, and clinical and histologic review(including architectural pattern, mitotic activity, nuclear grading) was performed retrospectively. The age of the patients ranged from 30 to 67 year(mean+S.D.; 46.0+11.8) and the mean parity was 1.2 (+1.3). Five(55.6%) of nine patients had elevated level of CA 125. The size of the tumors varied from 3 cm to 20 cm with the mean maximal diameter of 12.1 (+6.3) cm. The FIGO stages of the patients were IC(6 cases, 66.7%), IIC (2 cases, 22.2%) and IV(1 case, 11.1%). All patients except one were treated by total abdominal hysterectomy and bilateral salpingoophorectomy with or without omentectomy and pelvic lymph node dissection. All except two were received postoperative chemotherapy with regimens such as CEC (cyclophosphamide + epirubicin + carboplatin), TC(taxol + carboplatin), CC(cyclophosphamide + carboplatin) or CAP (cyclophosphamide + adriamycin + cisplatin). The mean follow-up duration was 14.6 (+ 8.6) months and 8 patients were free of disease and one patient with stage IV disease died of disease during postoperative chemotherapy(4 months after surgery).
Chungcheongnam-do ; Doxorubicin ; Drug Therapy ; Epirubicin ; Female ; Follow-Up Studies ; Gynecology ; Humans ; Hysterectomy ; Lymph Node Excision ; Obstetrics ; Ovary* ; Parity ; Prognosis ; Retrospective Studies ; Ulsan

STUDY DESIGN: A retrospective comparative study. PURPOSE: To provide an ideal correction angle of lumbar lordosis (LL) in degenerative flat back deformity. OVERVIEW OF LITERATURE: The degree of correction in degenerative flat back in relation to pelvic incidence (PI) remains controversial. METHODS: Forty-nine patients with flat back deformity who underwent corrective surgery were enrolled. Posterior-anterior-posterior sequential operation was performed. Mean age and mean follow-up period was 65.6 years and 24.2 months, respectively. We divided the patients into two groups based on immediate postoperative radiographs-optimal correction (OC) group (PI-9degrees< or =LL or =55degrees). Radiological and clinical results were analyzed. RESULTS: Patients in OC group had significantly less correction loss and maintained normal sagittal alignment (sagittal vertical axis<5 cm), as compared to patients in UC group (p<0.05). LL of low PI group significantly maintained within 9degrees better than high PI group (p<0.05). Oswestry disability index (ODI) significantly decreased at last follow-up, as compared to preoperative state. However, there was no significant difference in last follow-up ODI between the groups. CONCLUSIONS: In flat back deformity, correction of LL to within 9degrees of PI will result in better sagittal balance. Thus, we recommend sufficient LL to prevent correction loss, especially in patients with high PI.
Animals ; Congenital Abnormalities* ; Follow-Up Studies ; Humans ; Incidence ; Lordosis* ; Retrospective Studies

Renal cell Carcinoma is an unusual cancer with the propensity to invade not only the renal vein but to propagate into the inferior vena cava(IVC) as a tumor thrombus. No tumor thrombus extending to the IVC was seen in a renal cell carcinoma less than 4.5 cm in the greatest diameter among 431 consecutive patients in the Mayo Clinic from January 1976 to January 1992. The present case was a 3.5 cm in size small renal cell carcinoma on the right upper pole which had a tumor thrombus which extended to the inferior vena cava.
Carcinoma, Renal Cell* ; Humans ; Renal Veins ; Thrombosis* ; Vena Cava, Inferior*

Inverted papilloma of the urinary bladder is a rare urothelial neoplasm, almost benign in its histologic morphology and clinical behavior. It occurs mainly in males and in the region of the trigone of bladder, or posterior urethra. But, it may arise in the renal pelvis. The characteristic downward proliferation of urothelial cells within the underlying lamina propria is of such magnitude as to an exophytic papillomatous tumor. The lesion may be easily mistaken for a low- grade papillary transitional cell carcinoma, although the histologic appearance is distinctly different, as is its subsequent behavior. Because of distinctive histologic features and patterns of growth it is possible to differentiate between two basic types of inverted papillomatous which were termed "trabecular" and "glandular". The trabecular type consists of widely branched, anastomosing cords of urothelial cells originating directly from the overlying transitional epithelium. The glandular type develops apparently from a proliferative cystitis cystica and glandularis which, therefore, should be considered a potentially preneoplastic lesion. The malignant tendency is now being reported with inverted papillomas of urinary tract and therefore they are no longer regarded as innocuous benign neoplasms. We report the 3 cases of inverted papilloma of the urinary bladder with a brief review of literature.
Carcinoma, Transitional Cell ; Cystitis ; Epithelium ; Humans ; Kidney Pelvis ; Male ; Mucous Membrane ; Papilloma, Inverted* ; Urethra ; Urinary Bladder* ; Urinary Tract