BACKGROUND: Since method for calculating the risk of Down's syndrome pregnancy using the mothers alphafetoprotein(AFP), chorionic gonadotropin(CG) and unconjugated Estriol(uE3) levels in serum was developed, many reports showed the method including triple markers was more effective than calculating the risk only by the mother's age. Authors developed a computer program which could calculate the risk conveniently. We compared it with the established program and explained the calculating logic used in the program to help the readers to make their own computer program. METHODS: The risk of Down's syndrome pregnancy for age was calculated by the method of Cuckle, and medians of the CG, AFP, uE3 according to the days of pregnancy was calculated by Wald. Delphi(version 4.5, Inprise/Borland Corp., Scotts Valley CA, USA) was used as a programing language. We compared the risks of the pregnant women previously reported by the established computer program with those calculated by new computer program. RESULTS: In this program, user put down patient's demographic information and the results of each tests and press the command button then the user can see the calculated risk in one screen. User can use newly calculated median value according to their own accumulated data. There were almost no differences in risks between the program and formerly established one. CONCLUSIONS: The computer program developed by authors was agreed well with the established one, so this program could replace the latter. We hope there are many programs developed by readers in the future.
Chorion ; Down Syndrome* ; Female ; Hope ; Humans ; Logic ; Mass Screening* ; Mothers* ; Pregnancy ; Pregnant Women ; Risk Factors

BACKGROUND: Nasal polyps were developed from eosinophil infiltrations and activation by chronic inflammatory reactions. Eotaxin and RANTES have been postulated to be involved in the recruitment and activation of eosinophils to the inflamed tissues. The aim of this study is to estimate the mRNA expression of eotaxin and RNATES in the nasal polyps and it's effect on tissue eosinophils. METHODS: At first, we evaluated the linearity and precision of GeneAmp 5700R(PE Applied Biosystems, Foster, U.S.A) with M. tuberculosis DNA. We collected 17 allergic, 30 non-allergic nasal polyps and 15 normal inferior turbinates from the patients visiting Catholic University Hospital of Taegu Hyosung. We performed the quantitative polymerase chain reaction(PCR) for the eotaxin and RNATES, and the tissue immunohistochemical stain for the major basic protein. RESULTS: GeneAmp 5700R disclosed good linearity and precision. Compared with the normal inferior turbinates, eotaxin mRNA levels were increased in the allergic and non-allergic polyps, and showed significant correlation with eosinophils infiltration and activation. But the RANTES didn't revealed any significant differences among these groups, and no correlation with tissue eosinophils. The patients with allergic polyps showed increased eosinophils infiltration and activation in the tissue, while those with non allergic polyps disclosed increased eosinophils activation. CONCLUSIONS: Since eotaxin expression were increased in the tissue of the patients with nasal polyps and showed good correlation with eosinophils infiltration and activation in the tissue, it had been considered that eotaxin played an important role in the pathogenesis of allergic polyps and tissue eosinophilia.
Chemokine CCL5* ; Daegu ; DNA ; Eosinophilia ; Eosinophils ; Humans ; Nasal Polyps* ; Polyps ; RNA, Messenger* ; Tuberculosis ; Turbinates

BACKGROUND: To detect anti-human leukocyte antigen(HLA) class I alloantibodies in patients awaiting solid organ transplantation, panel reactive antibody(PRA) test using complement-dependent lymphocytotoxicity(CDC) has been used. The enough size of lymphocyte panel in PRA test enables the identification of HLA antibody specificities. So we made lymphocyte panel of 72 wells to evaluate the usefulness comparing with 36 wells screening panel. METHODS: A total of 55 sera(positive 20, negative 25, quality control materials provided by "International Cell Exchange" program of UCLA Tissue Typing Laboratory 10), which had been tested for PRA using 36 wells screening panel, were re-tested using newly produced 72 wells lymphocyte panel. RESULTS: The results of the 25 negative sera were same except one serum, which might be due to non-specific reaction. The %PRA values of the 20 positive sera using 36 wells screening panel were distributed into 1-10%(n=4), 10-50%(n=9), 50-80%(n=5), and 80-100%(n=2). Using lymphocyte panel of 72 wells, %PRA values of 20 positive sera showed no difference(p=0.61) from that of 36 wells and we could not identify the specificity of HLA antibodies for the 10 sera, which previously had not been identified with 36 wells screening panel. But we additionally or newly identified the specificity of HLA antibodies in 4 positive sera and 2 quality control materials. CONCLUSION: Identification of HLA antibodies was not much improved using a PRA test with 72 lymphocyte panel and therefore 36 lymphocyte panel is considered to be enough to screen the HLA antibodies. However the increase of the size of lymphocyte panel is expected to resolve the difficulty, caused by linkage disequilibrium, for the identification of HLA antibody specificity.
Antibodies ; Antibody Specificity* ; Centers for Disease Control and Prevention (U.S.) ; Histocompatibility Testing ; Humans ; Isoantibodies ; Leukocytes ; Linkage Disequilibrium ; Lymphocytes* ; Mass Screening ; Organ Transplantation ; Quality Control ; Sensitivity and Specificity ; Transplants

We report a case of Strongyloides stercoralis infection in a 85-year-old male patient who had complained of poor oral intake, diarrhea, and upper abdominal pain for 6 months. At admission, he showed severe eosinophilia in peripheral blood. Rhabditiform larvae were detected in the stool examination on the 15th admission day and developed into filariform larvae with a notched tail after stool culture by the Harada-Mori method. The patient received albendazole therapy for 7 days but no improvement were observed and he fell into pulmonary edema and coma.
Abdominal Pain ; Aged, 80 and over ; Albendazole ; Coma ; Diarrhea ; Eosinophilia* ; Humans ; Larva ; Male ; Pulmonary Edema ; Strongyloides stercoralis* ; Strongyloides*

BACKGROUND: Rapid detection of bacteriuria is desirable for diagnosis and treatment of urinary tract infections. The aim of this study was to assess the usefulness of the cytocentrifuge Gram stain, uncentrifuged Gram stain, and urinary nitrite, leukocyte esterase to determine the exclusion of urine culture. METHODS: A cytocentrifuge Gram stain procedure and urine dipstick test were performed to screen for bacteriuria using 155 random fresh urine specimens submitted for routine culture. The authors compared the results of the cytocentrifuge Gram stain, urinary nitrite, leukocyte esterase and multiapplication of three tests with the results of culture. Result: Compared with positive urine culture(>105CFU/mL), cytocentrifuge Gram stain had a good negative predictive value(96.0%) and sensitivity(89.1%). The urinary nitrite and leukocyte esterase test had very low sensitivity(27.0%, 45.9%), respectively. The multiapplication of cytocentrifuge Gram stain, urinary nitrite and leukocyte esterase had a excellent negative predictive value(98.9%) and sensitivity(97.3%), and agree with urine culture positive(36/37 cases, 97.3%). CONCLUSION: Multiapplication of urinary cytocentrifuge Gram stain, nitrite and leukocyte esterase test is a useful screening test for the rapid exclusion of bacteriuria and provides rapid morphologic information about suspected pathogens in cases with positive urine culture.
Bacteriuria* ; Diagnosis ; Leukocytes ; Mass Screening* ; Urinary Tract Infections

BACKGROUND: Recently Escherichia coli isolates with extended-spectrum beta-lactamase(ESBL) have been increased in Korea. ESBLs confer variable levels of resistance to cefotaxime, ceftazidime and other broad-spectrum cephalosporins as well as to monobactams such as aztreonam, but they have no detectable activity against cephamycins and carbapenems. The aim of this study was to characterize the ESBL produced by E. coli strains isolated from clinical specimens. METHODS: From March to July, 1998, a total of 93 clinical isolates of E. coli, which was produced ESBL, were collected from patients of the Asan Medical Center. The isolates flagged as ESBL producers by microbroth dilution antibiotic susceptibility test were confirmed by the double disk synergy test. Minimal inhibitory concentration(MIC) of beta-lactams were determined by agar dilution method. The presence of TEM, SHV or CMY-1 gene was determined by polymerase chain reaction. The types of beta-lactamase gene were determined by isoelectric focusing and nucleotide sequence analysis. RESULTS: Sixty-two strains carried plasmid-mediated TEM-52 gene, which sequence showed the substitution of 3 amino acids compared to that of TEM-1. Seventeen strains produced SHV-12, six strains produced SHV-2a, three strains produced TEM-52 and SHV-12, three strains produced TEM-52 and SHV-2a, and one strain produced SHV-2a and SHV-12. One out of twenty-seven strains of cefoxitin-resistant E. coli was confirmed to have CMY-1 beta-lactamase by PCR and nucleotide sequence analysis. CONCLUSIONS: TEM-52 was the most prevalent in E. coli isolates. The most common SHV-types of ESBL in Korea are SHV-12 and SHV-2a in E. coli isolates. In Korea, widespread use of oxyimino-cephalosporins in the hospitals has dramatically increased the prevalence of ESBL-producers in E. coli. Therefore, more prudent use of antibiotics is necessary to reduce the spread of these resistant organisms.
Agar ; Amino Acids ; Anti-Bacterial Agents ; Aztreonam ; Base Sequence ; beta-Lactamases* ; beta-Lactams ; Carbapenems ; Cefotaxime ; Ceftazidime ; Cephalosporins ; Cephamycins ; Chungcheongnam-do ; Escherichia coli* ; Escherichia* ; Humans ; Isoelectric Focusing ; Korea ; Monobactams ; Polymerase Chain Reaction ; Prevalence

BACKGROUND: The rising incidence of fungal infections and the increasingly frequent use of antifungal agents have intensified the need for practical and reliable antifungal susceptibility test methods. In the present study, the minimal inhibitory concentration(MIC) distribution of Candida species was investigated and the agar dilution method was compared with the National Committee for Clinical Laboratory Standards(NCCLS) "reference" broth microdilution method for antifungal susceptibility testing. METHODS: A total of 116 clinical isolates of Candida species from patients at Hanyang University Kuri Hospital were studied from October 1997 to July 1999, and the MICs of Candida species were evaluated against amphotericin B and fluconazole by the NCCLS method and the agar dilution method. RESULTS: There were no differences in the MIC50 and MIC90 of Candida albicans and Candida tropicalis against amphotericin B between the two methods, but the MIC50 of C. albicans against fluconazole was higher in the agar dilution method than in the broth microdilution method. The resistant rate of C. albicans against fluconazole was 20.8% in the broth microdilution method and 33.8% in the agar dilution method. For C. tropicalis, 31.3% were resistant to fluconazole in the broth microdilution method and 25.0% in the agar dilution method. The agreement of C. albicans and C. tropicalis between the agar dulution method and the broth microdilution method within one doubling dilution of the microdilution reference were 88.8% for amphotericin B and 34.4% for fluconazole. CONCLUSIONS: The MICs of amphotericin B showed good agreement between the agar dilution and the broth microdilution method. Therefore, resistant strains could easily be detected by screening with agar of 2 g/mL concentrations. However, in the case of fluconazole, the agreement between the two methods was low and the trailing effect could not be ruled out in agar dilution method with some strains, indicating the need for further studies in this area.
Agar* ; Amphotericin B* ; Antifungal Agents ; Candida albicans ; Candida tropicalis ; Candida* ; Fluconazole* ; Humans ; Incidence ; Mass Screening

BACKGROUND: BACTEC MGIT 960 system(Becton Dickinson, USA; MGIT 960) is a fully automated, noninvasive culture system for mycobacteria, which has been regarded as a sensitive and least labor-intensive method. This study was purposed to evaluate the performance of MGIT 960 compared to BACTEC 460 TB radiometric system(Becton Dickinson, USA; BACTEC 460) and Ogawa media. METHODS: A total of 1,067 clinical specimens submitted from April to June in 1999 was cultured for acid fast bacilli(AFB). All specimens were digested, decontaminated by the 6% sodium hydroxide(final concentration of 1.5%) and 0.5% N-acetyl-L-cysteine method. All specimens were inoculated into three kinds of media: a MGIT, a BACTEC 12B, and an Ogawa medium. The AFB recovered from cultures were identified to M. tuberculosis complex and MOTT by NAP test. RESULTS: Of 106 isolates of M. tuberculosis recovered from all culture systems, 101(95.3 %) were detected in the MGIT 960, 95(89.6%) in the BACTEC 460 and 76(71.7%) on Ogawa media. MGIT 960 plus Ogawa media detected 104(98.1%) isolates and BACTEC 460 plus Ogawa media recovered 96(90.6%) isolates. The mean time required for detection of M. tuberculosis was 12.7+/-5.8 days with MGIT 960, 16.2+/-7.7 days with BACTEC 460, and 22.8+/-9.5 days with Ogawa media. The contamination rate were 5.1% for MGIT 960, 2.7% for BACTEC 460, and 6.7% for Ogawa media. CONCLUSIONS: MGIT 960 is a sensitive and rapid method to isolate M. tuberculosis.
Acetylcysteine ; Mycobacterium tuberculosis* ; Mycobacterium* ; Sodium ; Tuberculosis

BACKGROUND: High-level gentamicin and streptomycin disks are not easily available, despite their critical role in detection of high-level resistance to aminoglycosides in enterococci. Therefore, the possibility of applicating home-made disks to test high-level resistance of enterococci to aminoglycosides was evaluated. METHODS: The disk diffusion method using home-made disks was compared with minimal inhibitory concentrations(MIC) in 53 clinical isolates of enterococci, and, the stability of the disks were also evaluated by disk diffusion testing, biweekly, for 14 weeks. RESULTS: The high-level resistance rates to gentamicin(GM) and streptomycin(SM) were 60% and 43%, respectively. Thirty eight % of the enterococci were highly resistant in both GM and SM. The results of the disk diffusion method were consistent with the MIC until 10 weeks after production of the disks. After 12 weeks, the inhibition zones of GM- or SM-susceptible strains decreased by 2.9-3.9 mm, and the discrepancy rates were 5-24% between the results of the MIC and disk diffusion method. The storage temperature of -20degrees C versus -70degrees C showed no difference in the inhibition zone. CONCLUSION: It has been demonstrated that home-made high-level GM and SM disks are stable at -20degrees C for 10 weeks, and the results of disk diffusion method on the disks show they are applicable for the test of susceptibility of aminoglycosides to enterococci.
Aminoglycosides ; Diffusion ; Enterococcus ; Gentamicins ; Streptomycin

BACKGROUND: Urinary bladder cancer has been diagnosed by urine cytology and cystoscopy with biopsy. Recently, in vitro noninvasive diagnostic tests, measuring urinary nuclear matrix protein22(NMP22) and bladder tumor antigen(BTA), were introduced. We analyzed the usefulness of the NMP22 and BTA tests for diagnosing bladder cancer and compared those with voided urine cytology. MATERIALS AND METHODS: Single voided urine specimens were obtained from 27 patients with bladder cancer and 23 healthy volunteers. The urine specimens were assayed by enzyme immunoassay(NMP22, Matrietech(R), Newton, MA.) and latex immunoassay(BTA, Bard, USA). Urine cytology was performed in patients with bladder cancer. RESULTS: Mean urinary NMP22 level of patients with bladder cancer(144.6 U/mL) was significantly higher than those of normal controls(2.9 U/mL, P<0.01). The sensitivities were 89% and 74% for NMP22 and BTA tests, respectively, compared with 41% for voided urine cytology. The sensitivities of NMP22 and BTA tests were 88%, 63% at grade 1(G1), 82%, 73% at G2, and 100%, 88% at G3, respectively(P<0.01; NMP22, P=0.580; BTA). According to tumor stage, the sensitivities of NMP22 and BTA tests were both 79% at superficial, and 100% and 69% at invasive cancer, respectively(P=0.110; NMP22, P=0.678; BTA). The sensitivities of urine NMP22 and BTA tests combined with urine cytology were both 96%. In following of transitional cell carcinoma patients, agreement between urine cytology and BTA test was 75%(24/32). Among the various urologic disease, false positive rate for BTA test was 17%(8/47). CONCLUSION: Urinary NMP22 and BTA tests were more sensitive than voided urine cytology regardless of tumor grade and stage, so these noninvasive and simple tests can be used as screening tests for urinary bladder transitional cell carcinoma.
Biopsy ; Carcinoma, Transitional Cell* ; Cystoscopy ; Diagnostic Tests, Routine ; Healthy Volunteers ; Humans ; Latex ; Mass Screening* ; Nuclear Matrix ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urologic Diseases