BACKGROUND: Diagnosis of paucibacillary leprosy is difficult owing to lack of sensitive diagnostic tools. Recently, several investigators have studied the use of polymerase chain reaction(PCR) to detect Mycobacterium leprae. Using nested-PCR the sensitivity and specificity of DNA amplification is considerably improved. OBJECTIVE: The purpose of investigation is to assess the efficacy to nested-PCR which is applied to formalin-fixed, paraffin-embedded biopsies material of patients with leprosy. METHODS: Biopsy samples were taken from patients with lepromatous(11 patients) and tuberculoid (10 patients) leprosy, fixed in formalin, and embedded in paraffin. The DNA from samples was extracted and amplified through 25 cycles by using the outside pairs of primer(L1 and L2). The second amplification was allowed to proceed through 15 cycles using inside pairs of primer(L3 and L4). RESULTS: All twenty one samples showed 347-base-pair products. To confirm that the 347-bp product did correspond to the expected portion of the M. leprae groEL gene, the amplified product was digested with Pst I. Pst I digestion yielded 254-and 93-bp fragments, as predicted from the sequence of the M. leprae gene. The sensitivity was that a single organism was identified by nested-PCR. CONCLUSION: The nested-PCR is sensitive, specific, and simple diagnostic tool for leprosy.
Biopsy ; Diagnosis ; Digestion ; DNA* ; Formaldehyde ; Humans ; Leprosy ; Leprosy, Paucibacillary ; Mycobacterium leprae* ; Mycobacterium* ; Paraffin* ; Polymerase Chain Reaction* ; Research Personnel ; Sensitivity and Specificity

Chronic postirradiation changes of skin reflect the injury of dermal structures particularly the vasculature and connective tissue. The clinical signs include atrophy, partial or complete destruc tion of cutaneous appendatges, telangiectasis, sclerosis of underlying tissue, pigrnentary changes, and in rare instances, ulceration with or without var ious premalignant and malignant neoplasms. The patient, was a 65-year-old man, who had been exposed to a large amount. of X-ray irradi- ation on his hands incidentally or accidentally for a long time. The skin changes of his hand were thickening and hardening of all digits loss or focal consttict,ion of digits, and keratotic papules. Epidermal hyperplasia and fibrous thickening of collagen bundles were found on skin biopsy. Gradual narrowingal of the bony caliber with eventual resorption was noticed on radiologic examination. It has been rarely reported in the literature that chronic radiation dermatitis develops severe and unusal manifestions such as acrosclerosis and loss of digit due to osteoradionecrosis.
Aged ; Atrophy ; Biopsy ; Collagen ; Connective Tissue ; Dermatitis* ; Hand ; Humans ; Hyperplasia ; Osteoradionecrosis* ; Sclerosis ; Skin ; Telangiectasis ; Ulcer

BACKGROUND: It is well known that the cutaneous tuberculosis especially skin tuberculids is difficult to detect early and make a confirm diagnosis because the organism is seldom detected in a lesion by conventional methods such as AFB stain and culture. The polymerase chain reaction is a very powerful molecular biological tool in diagnosing infectious, neoplastic and genetic diseases. It has the merit of employing various samples, and to improving sensitivity by the modification of PCR techniques. Usage of the routinely formalin-fixed paraffin-embedded tissue as a sample for PCR is very useful in clinical examination, however the sensitivity and specificity have been known to be decreased. OBJECTIVE: To evaluate the efficacy of the nested-PCR in the diagnosis of different types of cutaneous tuberculosis, we tried to detect the DNA of Mycobacterium tuberculosis from routinely formalin-fixed paraffin-embedded tissue. METHODS: The various cutaneous tuberculosis and infectious granulomatous disease were retrospecitively selected by the findings of clinical, histopathological and bacterial culture. There were 9 cases of lupus vulgaris, 4 tuberculosis verrucosa cutis, 2 papulonecrotic tuberculid, 2 erythema induratum and 4 lupus miliaris disseminatus faciei. To amplify the 123bp DNA fragment of a repeated insertion sequence IS6110, two pairs of primers composing outside and inside primers were applied. RESULTS: The positive band was found in 10(91% ) of lupus vulgaris, 3 of tuberculosis verrucosa cutis, 1 papulonecrotic tuberculid and 1 erythema induratum. Four of the LMDF and 5 of the infectious granulomatous diseases were negative. CONCLUSION: The nested-PCR using routinely formalin-fixed paraffin-embedded tissue is a useful diagnostic tool if combined with the result of other clinical data. Also it may provide further insight into pathogenesis of skin tuberculids and the differential diagnosis of granulomatous skin diseases.
Diagnosis ; Diagnosis, Differential ; DNA ; Erythema Induratum ; Lupus Vulgaris ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Skin Diseases ; Skin* ; Tuberculosis ; Tuberculosis, Cutaneous*

BACKGROUND: It is well known that the cutaneous tuberculosis especially skin tuberculids is difficult to detect early and make a confirm diagnosis because the organism is seldom detected in a lesion by conventional methods such as AFB stain and culture. The polymerase chain reaction is a very powerful molecular biological tool in diagnosing infectious, neoplastic and genetic diseases. It has the merit of employing various samples, and to improving sensitivity by the modification of PCR techniques. Usage of the routinely formalin-fixed paraffin-embedded tissue as a sample for PCR is very useful in clinical examination, however the sensitivity and specificity have been known to be decreased. OBJECTIVE: To evaluate the efficacy of the nested-PCR in the diagnosis of different types of cutaneous tuberculosis, we tried to detect the DNA of Mycobacterium tuberculosis from routinely formalin-fixed paraffin-embedded tissue. METHODS: The various cutaneous tuberculosis and infectious granulomatous disease were retrospecitively selected by the findings of clinical, histopathological and bacterial culture. There were 9 cases of lupus vulgaris, 4 tuberculosis verrucosa cutis, 2 papulonecrotic tuberculid, 2 erythema induratum and 4 lupus miliaris disseminatus faciei. To amplify the 123bp DNA fragment of a repeated insertion sequence IS6110, two pairs of primers composing outside and inside primers were applied. RESULTS: The positive band was found in 10(91% ) of lupus vulgaris, 3 of tuberculosis verrucosa cutis, 1 papulonecrotic tuberculid and 1 erythema induratum. Four of the LMDF and 5 of the infectious granulomatous diseases were negative. CONCLUSION: The nested-PCR using routinely formalin-fixed paraffin-embedded tissue is a useful diagnostic tool if combined with the result of other clinical data. Also it may provide further insight into pathogenesis of skin tuberculids and the differential diagnosis of granulomatous skin diseases.
Diagnosis ; Diagnosis, Differential ; DNA ; Erythema Induratum ; Lupus Vulgaris ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Skin Diseases ; Skin* ; Tuberculosis ; Tuberculosis, Cutaneous*

No abstract available.
Coronary Artery Bypass* ; Coronary Vessels* ; Mortality*

Acute myocardial infarction (AMI) is rare in patients with idiopathic thrombocytopenic purpura (ITP). We describe a case of an AMI during thrombocytopenia in a patient with chronic ITP. A 47-yr-old woman presented with anterior chest pain and a low platelet count (21,000/microliter) at admission. Urgent coronary angiography revealed total occlusion of proximal right coronary artery and primary percutaneous coronary intervention (PCI) was performed successfully. This case suggests that primary PCI may be a therapeutic option for an AMI in patients with ITP, even though the patient had severe thrombocytopenia.
Purpura, Thrombocytopenic, Idiopathic/*complications/drug therapy ; Myocardial Infarction/*complications/*therapy ; Middle Aged ; Immunoglobulins, Intravenous/administration & dosage/adverse effects ; Humans ; Heparin/administration & dosage/adverse effects ; Female ; Anticoagulants/administration & dosage/adverse effects ; *Angioplasty, Transluminal, Percutaneous Coronary

To investigate determinants of health care utilization of the physically, disabled over 20 years old in age living in Taegu city, a self-administered questionnaire survey was carried out for 337 disabled persons with chronic illness from April to July, 1997. Health care utilization rate was 81.9%(69.l% for hospital or clinic and 12.8% for pharmacy). Marital status, job, health concern, and response to illness showed statistically, significant relationship with health care utilization(p<0.05). By, path analysis, job, economic status, medical security type and response to illness had a significant direct effect on health care utilization(p<0.05), however, health concern and regular source of care had an indirect effect. The reasons of no health utilization were due to economic problem(31.l%), no symptom(18.0%), inconvenience to seek care or no accompanying persons to be helped(14.8%), unseriousness of the severity of the illness(14.8%), too busy to be treated or no free time(8.2%), hopeless prognosis to be treated(6.6%) in order. In conclusion, it is recommended that the program for expanding medicaid, improving socioeconomic status by getting a job and health education to increase the health Concern toward physically disabled should be implemented to increase health care utilization rate.
Chronic Disease ; Daegu ; Delivery of Health Care* ; Disabled Persons* ; Health Education ; Humans ; Marital Status ; Medicaid ; Prognosis ; Surveys and Questionnaires ; Social Class ; Young Adult

PURPOSES: This study was conducted to determine the source of infection and mode of transmission of the shigellosis outbreak on March 27, 1998 at a primary school in Taegu city. METHODS: On-site interview using a standard questionnaire and rectal swab were conducted to 1,629 peoples who ate lunch on March 26 and 1,389 peoples who contacted with suspected cases. And bacteriological examination for 91 environmental materials and 25 food items were performed. RESULTS: Of the 1,629 persons who ate lunch on March 26, seventy three had culture-confirmed S. sonnei infection(first attack rate: 4.5%). And additional fifty four had shigellosis among those 1,389 persons who might be exposed to the suspected cases(second attack rate: 3.9%). A total of 730 persons who complained one of four typical symptoms or more were treated as suspected cases(first attack rate of suspected cases: 44.8%). S. sonnei was never isolated from water, foods, and other environmental materials. The median incubation period was estimated about two days. The common symptom reported were diarrhea(88.7%), fever(73.4%), abdominal pain(54.7%), and vomiting episode(38.4%) in order. The shorter duration of the outbreak and the large proportion of cases involving students who ate lunch on March 26 are consistent with fecal-oral transmission, although the limited epidemiologic data obtainable do not clearly define the route of transmission. CONCLUSIONS: Thus the outbreak reported here appear to be related to the unsanitary conditions of food facility in this school.
Daegu* ; Disease Outbreaks ; Dysentery, Bacillary ; Humans ; Incidence ; Lunch ; Shigella sonnei* ; Shigella* ; Vomiting ; Surveys and Questionnaires

PURPOSE: E-cadherin and CD44H have been shown to play a role in the progression and the metastasis of tumors. This study evaluated the clinical correlations between expression of E-cadherin and CD44H and various clinicopathologic factors and the value of expressions of E-cadherin and CD44H as prognostic factors in Borrmann type IV gastric cancer. MATERIALS AND METHODS: In 122 patients with Borrmann type IV gastric cancer, we performed the immunohistochemical stainings for E-cadherin and CD44H. We analyzed the correlation between the expressions of E-cadherin and CD44H and lymphatic invasion, venous invasion, perineural invasion, histologic type, lymph node metastasis, depth of invasion, stage, and peritoneal dissemination, and survival. RESULTS: There were no correlations between reduced expression of E-cadherin and CD44H and lymphatic invasion, venous invasion, perineural invasion, histologic type, lymph node metastasis, depth of invasion, and stage. However, there was a significant correlation between lymph node metastasis and the lymphatic invasion (P=0.022). There was also a significant correlation between the peritoneal dissemination and CD44H expression (P=0.005). The 5-year survival rate was correlated with CD44H expression (P=0.026), peritoneal dissemination (P<0.01), depth of invasion (P<0.01), lymph node metastasis (P<0.01), stage of tumor (P<0.01), and lymphatic invasion (P<0.01). There was no correlation between expression of E-cadherin and survival rate. CONCLUSION: The expression of CD44H and peritoneal dissemination was correlated. The expression of CD44H was an independent prognostic factor in Borrmann type IV gastric cancer. Further prospective studies with a large number of cases are required.
Cadherins* ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Stomach Neoplasms* ; Survival Rate

Guillain-Barré syndrome (GBS) is the most common immune-mediated polyradiculoneuropathy and it is also the most commonly reported severe adverse event following immunization in adults. To evaluate the results of clinical and laboratory features of GBS after vaccination in Korea, we analyzed the claims-based data from 2002 to 2014 using materials collected for the Advisory Committee Vaccination Injury Compensation (ACVIC) meeting including, clinical features, nerve conduction studies (NCSs), cerebrospinal fluid (CSF) profiles, treatment, and outcomes. Forty-eight compensated GBS cases (median age, 15 years; interquartile range [IQR], 13–51; male:female ratio, 1:1) of 68 suspected GBS were found following immunization and all of them with influenza immunizations with either monovalent (n = 35) or trivalent (n = 13). Among them, 30 cases fulfilled the Brighton criteria level 1–3 (62.5%). The median duration between the onset of symptoms to nadir, duration of the nadir, and total admission period were 3 (IQR, 2–7 days), 2 (IQR, 1–5 days), and 14 (IQR, 6–33 days) days, respectively. The most frequently reported symptom was quadriparesis which was present in 36 cases (75%) at nadir. CSF examination revealed albuminocytologic dissociation in 25.0% and NCS was abnormal in 61.8%. After treatment, most of them showed improvement. Clinical features were similar to typical post-infectious GBS and there were both demyelinating and axonal forms suggesting heterogeneous pathogenic mechanism. In order to improve the diagnostic certainty of post-vaccination GBS, careful documentation of clinical features and timely diagnostic work-up with follow-up studies are needed.
Adult ; Advisory Committees ; Axons ; Cerebrospinal Fluid ; Compensation and Redress ; Follow-Up Studies ; Guillain-Barre Syndrome* ; Humans ; Immunization ; Influenza, Human ; Korea* ; Neural Conduction ; Polyradiculoneuropathy ; Quadriplegia ; Vaccination