No abstract available.
Tuberculosis*

BACKGROUND: Definite criteria for the diagnosis and treatment evaluation for different clinical stags of syphilis are not yet present dute to the inability to dultivate Treponema pallidum in vitro. However, as the staining methods and the serological tests currently used have their limitations, a more definite method for its confirmation is needed. Polymerase chain reaction (PCR), due to its high sensitivity and specificity, is currently being applied to the detection of T. pallidum. OBJECTIVE: We have used PCR for the detection of T. pallidum DNA in various clinical specimens in orber to evaluate its potenital as a diagnostic tool. METHOD: Clinical specimens were collected from patients with different stages of syphilis who visited ithe Deparment of Dermatology of Yonsei medical Center for 1 year beginning from May, 1991. Sera from 63 patients, cerebrospinal fluids from 24 patients, amniotic fluids from 3 patients, and 21 tissues from 19 patients were subjected to PCR and the results were analyzed to evaluate its usefulness as a diagnostic and treatment evaluation tool. A portion of the T. pallidum-specific chromosomal DNA, tpp47, which encodes the 47 kDa surface protein, was used as the template DNA to amplify the 658 bp DNA fragment, and the following results were obtained. PCR using primers 47-1 and 47-2 were applied to amplify 658 bp DNA fragments from the T. pallidum-specific tpp47 gene encoding 47 kDa surface protein. RESULT: 1. To evaluate the sensitivity of the PCR, T. pallida and their chromosomal DNA were diluted. The diluents contataining a single organism and 1 fg of the chromosomal DNA showed positive reactions by the amplification. 2. Specificity of the PCR was determined by using T. pallidum, 4 species beloging to genus Treponema, and 9 species of nonpathogenic or pathogenic organisms. A positive reaction was obtained only when T. pallidum chromosomal DNA was used. 3. PCR was positive in 5 of 9 (55%) sera in primary syphilis, 22 of 26(84%) in secondary syphilis, 3 to 15(20%) in early latent syphilis, 1 of 19 (11%0 in late latent syphilis, 2 of 2 (100%) in neurosyphlis, and 0 of 2 (0%) in congenital syphilis. The differences in the positive rates were statistically significant (P<0.01) in all stages except neurosyphilis and congenital syphilis, as their numbers were too smalll to deduce any significant meaning. Despite their high VDRL titers, the positive rate in early latent syphilis was relatively low when compared to the rate in secondary syphilis. 4. Follw-up PCR of sera in some patients showed positive results 9 months after treatment. However, some with negative PCR before treatment showed positive results after treatment. 5. PCR was positive in 1 of 1 (50%) cerebrospinal fluid in primary syphilis, 3 of 14 (21%) in secondary syphilis, 2 of 7 (29%) in early latent syphilis, and 1 of 1(100%) in neurosyphlis. The differences in the positive rates showed no statistical significance in relation to the clinical stages. Cerebrospinal fluid VDRL test, white blood cell count, and protein content showed no correlation to the PCR results in early syphilis patients. 6. Amniotic fluid showed a positive PCR result only in a pregnant woman whose serum showed a high VDRL titer and a positive PCR. 7. PCR positive rates were 90% in frozed tissues and 50% in paraffin embedded tissues. CONCLUSION: From the results, it is suggested that PCR is not suitable for treatment evaluation but is useful for the detection of T. pallidum in sera of secondary syphilis patients and syphilitic lesions, and for the confirmation of the diagnosis the diagnosis in these cases.
Amniotic Fluid ; Cerebrospinal Fluid ; Dermatology ; Diagnosis ; DNA ; Female ; Humans ; Leukocyte Count ; Neurosyphilis ; Paraffin ; Polymerase Chain Reaction* ; Pregnant Women ; Sensitivity and Specificity ; Serologic Tests ; Syphilis ; Syphilis, Congenital ; Syphilis, Latent ; Treponema pallidum* ; Treponema*

Using the FTA-ABS complernent test, 32 skin speciruens from 27 patients with primary and secondary syphilis and a stomach specimen from a patient with suspected gastric syphilis which were confirmed by clinical history, physical examination, VDRL, FTA-ABS, and 19S(IgM)-FTA test, were tested. The following results were obtained. 1. In the darkfield examination, 7 of the 9 specimens(78%) were positive and in the FTA-ABS complernent test, 20 of the 33 specimens(61%) were positive. 2. The ratio of agreement between the darkfield examination and the FTA-ABS complement test was 89%. 3. In the chancres, macular syphilids, and condyloma lata, T. pallida were diffusely scattered in the epidermis, dermoepidermal junction, connective tiasue, and vascular walls, whereas in the papular syphilid T. pallida were mainly aggregated in the the epidermis, dermoepidermal junction, papillary dermis as well as the blood vessel walls in the papillary dermis. From these results, the FTA-ABS complement test can be considered to be a useful method for both the diagnosis and research of syphilis. It is especially helpful in cases where serological or histopathological study can not confirrn the diagnosis as when internal organs are involved.
Blood Vessels ; Chancre ; Complement System Proteins* ; Dermis ; Diagnosis ; Epidermis ; Humans ; Physical Examination ; Skin ; Stomach ; Syphilis ; Syphilis, Cutaneous ; Treponema pallidum* ; Treponema*

No abstract available.
Catheters*

No abstract available.
Humans ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy*

1. Fifty one cases of fractures of the shaft of the femur in children, treated at Seoul National University Hospital during the seven years, from August 1962 to July 1969, were analyzed. 2. In thirty eight of the cases fracture involved the middle third of the shaft, in eleven the upper third, and in two the lower third. 3. Bryant traction was employed in fifteen of the cases ranging from four months to six years of age. One case, five years old, was complicated by Volkmanns ischemic contracture on both legs. 4. Russell traction was employed in eleven of the cases ranging from six to fourteen years of age. Angulation and distraction must be watched especially in the younger age group, although we encountered no serious complications which required subsequent treatment. 5. Hoke traction was employed in twelve of the cases ranging from six to eleven years of age. Although this form of treatment is not particularly popular, we are of the opinion that it is the treatment of choice over two years of age and,under six years of age and that between six and twelve years of age it may be optionally employed along with Russell traction. We found it. particularly useful and convenient in selected cases in which Russell traction could not be effectively employed. 6. In some of the complicated cases, open reduction and internal fixation, closed reduction with pin and plaster immobilization, or skeletal traction was employed.
Child ; Femur ; Humans ; Immobilization ; Ischemic Contracture ; Leg ; Seoul ; Traction

The patellar tendon is known as the strongest material for the substitution of anterior cruciate ligament. There are many technical difficulties in reconstruction of the ligament with this tendon since patellar aponeurosis is weak, and the length of the tendon is restricted, and the adquate insertion in proper place is difficult. Authors harvested the middle 1/3 of patellar tendon c bone block of tibial tubercle and patella with the superficial layer of the quadriceps tendon left attached. The large triangular tibial tubercle piece was impacted into the femoral tunnel from distally to proximally, of which the orifice is the very place of the middle of the original anterior cruciate ligament. Two bundles of 0-dexon sutures made at the tibial tubercle portion, were pulled through to different outlet of femoral condyle during this procedure and were tied over the cortical bone of lateral supracondylar region. The tendon twisted 180°(clockwise for the right knee and counter-clockwise for the left knee) to adapt to screwhome movement. The patellar piece was fixed at the isometric point in full flexion and extension, which is usually the middle point of original tibial insertion c one or two barbed staples made at the original position of tibial insertion of the ligament. We tried this methods in 26 knees (12 vascularized grafts and 14 free grafts) and was followed for more than one year and the results was compared with those of 12 knees of original McIntosh operation (follow up period: 16-72 months, average 34.3 months). The instability were evaluated c Lachman test and OSI sagittal knee tester. The knee of negative Lachman test & pivot shift test was defined as "normal" The results were as follows;l. In modified McIntosh operation group negative Lachman test was noted only in 6 knees (50.0 % ) and there were 2 knees (16.7% ) of GI, II & III, respectively. 2. In vascularized bone block patellar tendon graft group II out of 12 knees (91.7%) showed negative Lachman test and only one knee (8.3%) revealed G II. 3. In free bone block patellar tendon graft 13 out of 14 knees (92.9%) showed negative Lachman test and the other one knee (7.1%) revealed GI. 4, The overall success rate (normal) of bone block patellar tendon graft was 92.3%. The success rate of patellar tendon bone block operation was significantly higher than that of modified McIntosh operation (χ²=6.48, df=1, P=0.0109) and there was no statististical difference between vascularized and free graft group (χ²=0.39, df=l, P=0.5322).
Anterior Cruciate Ligament ; Knee ; Ligaments ; Patella ; Patellar Ligament ; Sutures ; Tendons ; Transplants

There are many options for the management of osteoarthritis of the knee joint. Recently, arthroscopic surgery has been added to the armamentorium of the treatment modalities in osteoarthritis of the knee which does not respond to conservative treatment. Among 74 arthroscopic pocedures(including partial menisectomy, removal of loose bodies, synovectomy, cartilage drilling and simple lavage) done for osteoarthritis of the knee, 68 patients studied at average 3.1 years after procedure and the results were as follows 1. Seventy-one percent of patients had at least 2.5 years or more relief of pain and symptoms. 2. Fifty-six percent were still good at follow-up of 3.1 years. 3. The best result were obtained after removal of loose bodies and resection of unstable flap tear of a meniscus in association with mild osteoarthritis. 4. The poor result were obtained in patients with severe degenerative changes of both femoral condyle, 5. The results were much better in the normally aligned knee compared with valgus knee.
Arthroscopy ; Cartilage ; Follow-Up Studies ; Humans ; Knee Joint ; Knee ; Osteoarthritis ; Tears

BACKGROUNDS: An inhibitory effect of magnesium L-ascorbyl-2-phosphate (VC-PMG, a stable derivative of ascorbic acid) on melanogenesis has been described. Furthermore, glabridin in licorice is known to have inhibitory effects on melanogenesis and widely used for raw materials for depigmenting agents. OBJECTIVE: The purposes of this study are to provide objective data by measuring the visual clinical effects of VC-PMG with the colorimeter and to promote the development of de-pigmenting agents. METHODS: 20 volunteers joined the study. With an artificial UVB irradiation, eight tanned areas were made on the inner side of the forearm. During two months, each tanned area was treated with five whitening cosmetics with 3% VC-PMG and increasing concentration of licorice from 0% to 3%. Darkness degree of each area was measured weekly by the colorimeter and the visual assessment. RESULTS: For all cosmetics, whitening effect was measured by colorimeter and visual as-sessment. The cosmetic containing VC-PMG 3% and licorice 1% had more whitening effect than any other cosmetics of different concentrations. Moreover, VC-PMG 3% alone also had whitening effect in some volunteers. CONCLUSION: VC-PMG was clinically found to have whitening effect.
Ascorbic Acid* ; Darkness ; Forearm ; Glycyrrhiza ; Magnesium* ; Triacetoneamine-N-Oxyl ; Vitamins* ; Volunteers

Cavernous lymphangioma in mediastinum is a rare congenital malformation of lymphatic system and is caused by lack of adequate drainage from the sequestrated lymphatic vessels to the venous system due to insufficiency or atresia of the efferent lymphatic channels The authors experienced 10 month-old male patient with cavernous lymphangioma in mediastinum documented by chest CT and open biopsy The review of the literature was made briefly.
Biopsy ; Drainage ; Humans ; Infant ; Lymphangioma* ; Lymphatic System ; Lymphatic Vessels ; Male ; Mediastinum* ; Tomography, X-Ray Computed