No abstract available.
Abdomen* ; Humans

BACKGROUND: The detection of specific autoantibodies in the sera of patients with systemic rheumatic diseases plays a key role in the differential diagnosis. Enzyme-linked immunosorbent assays (ELISA) is known as sensitive and semiquantitative method to detect autoantibodies and ELISA kits using a recombinant fusion protein as antigen have been developed. So, various commercial ELISA have recently become available in a diagnostic laboratory. We investigated the clinical value of antinuclear autoantibodies using commercial ELISA kits. METHODS: The serum of 90 patients were tested for autoantibodies to SSA/Ro, SSB/La, nRNP/Sm and Sm antigens by ELISA using four commercial kits, EL-ANA(TM) (TheraTest, IL, USA), DIASTAT(TM)(SHIELD, DUNDEE, UK), QUANTALit(TM) (INOVA, CA, USA), Varelisa(TM) (elias, WI, USA). We evaluated the clinical usefulness of panel test of Varelisa(TM) in the diagnosis of systemic rheumatic diseases. RESULTS: The concordance rates of four ELISA kits for autoantibodies to SSA/Ro, SSB/La, RNP/Sm and Sm antigens were 83.6%, 74.5%, 87.5% and 80.0%, respectively. Using panel test of Varelisa(TM), positive rates of autoantibodies to Ul-snRNP, nRNP/Sm, Sm, SSA/Ro, SSB/La, Scl-70, CENP and Jo-1 antigens in SLE were 30.0, 40.0, 33.3, 46.7, 20.0, 20.0, 10.0, and 0%, respectively. Of 30 patients with SLE, 16 (53.3%) were positive for 2 or more antibodies. CONCLUSIONS: EL-ANA(TM), QUANTALite(TM) and Varelisa(TM) show more positive rates than DIASTAT(TM). The difference in the positive rates among four commercial ELISA kits may come from the different antigen sources. The panel test of 8 autoantibodies using Varelisa(TM) ELISA kit offers discriminative power and enhances the specificity of the assay in patients who lack clear evidence of clinically definite autoimmune disease.
Antibodies ; Autoantibodies* ; Autoimmune Diseases ; Diagnosis ; Diagnosis, Differential ; Enzyme-Linked Immunosorbent Assay* ; Histidine-tRNA Ligase ; Humans ; Rheumatic Diseases ; Sensitivity and Specificity ; Staphylococcal Protein A

Retroperitoneal teratoma is a rare disease, which contains all three germ layers, and mostly occurs in childhood. A case of retroperitoneal teratoma in a 6-month old male infant in the left abdomen is presented. This huge rumor mass and left kidney were widely removed.
Abdomen ; Germ Layers ; Humans ; Infant ; Kidney ; Male ; Rare Diseases ; Teratoma*

The PACS system built and used in hospitals nowadays has quite significant overload on the central server of it because of both treatment of very large data and full management of medical images. We suggest a distributed communication and management methodology using Peer to Peer multicasting strategy for efficient management of medical images produced by DICOM modalities. It is absolutely necessary for reducing strict degradation of PACS system due to large size of medical images and its very high transport rates. DICOM Peer to Peer component is composed a service manager to execute requested queries, a communication manager to take charge of file transmission, and a DICOM manager to manage stored data and system behavior. Each manager itself is a component to search for requested file by interaction or transmit the file to other Peers. Distributed management and transformation of medical information based on Peer to Peer multicasting methodology will enhance performance of central server and network capacity reducing overload on them.

BACKGROUND: Recently, new plasmid-mediated extended-spectrum beta-lactamases have been reported. These are not derived from TEM or SHV enzymes but are related to cephalosporins of Enterobacteriaceae (AmpCenzymes), that confer to all cephalosporins including cefoxitin. METHODS: Fifteen clinical isolates of cefoxitin-resistant Klebsiella pneumoniae were charaterized. Antimicroilutin method. Crude beta-lactamases were prepared by sonication and isoelectric focusing of the enzyme preparations was performed in polyacrylamide gel. The transmissibility of resistance was tested by mating to E. coli J53. We performed PCR and hybridization for further characterization of the AmpC-type beta-lactamse. RESULTS: Seven strains were found to have the plasmid-mediated AmpC type beta-lactamase as a pI of 8.0 and this was confirmed to be cmy-1 beta-lactamase by PCR and hybridization analysis. These strains were resistant to ampicillin and piperacillin with MICs above 128microgram/ml. Cefoxitin resistance could be transferred from 4 strains via a large plasmi with molecular sizes approximately 77 or 130 kb. The molecular weight of CMY-1 enzyme is approximately 38kDa. We analyzed the OMP of six cefoxitin-resistance K. pneumoniae. Two of six strains were lacking a major OMP of approximately 40 kDa, but four of them showed another 39 kDa sized band just below the 40 kDa major OMP, which were thought to be a modified 40 kDa OMP. CONCLUSION: With these results, we conclude that resistance to cefoxitin in K. pneumoniae isolated from Korean patients is either associated with the productin of CMY-a, a plasmid-mediated AmpC type beta-lactamase, of altered expressin of an outer membrane protein.
Ampicillin ; beta-Lactamases* ; beta-Lactams ; Cefoxitin ; Cephalosporins ; Enterobacteriaceae ; Humans ; Isoelectric Focusing ; Klebsiella pneumoniae* ; Klebsiella* ; Membrane Proteins ; Molecular Weight ; Piperacillin ; Pneumonia ; Polymerase Chain Reaction ; Sonication

No abstract available.
Humans ; Kidney Transplantation*

Although Guillain Barre sydrome(GBS) is known to be a demylinating disease of the peripheral nervous system, it has been rarely repored that GBS was accompanied by demyelinating disease of the central nervous system such as multiple sclerosis, optic neuritis or acute disseminated encephalomyelitis. We experienced a patients with GBS who developed unilateral opticneuritis. A 19-year-old male patient was presented with ascending weakness. A few days later, he complained of decreased visual acuity and pain on the right eye. Cerebrospinal fluid findings were compatible with GBS and serial visual evoked potential studies were indicative of optic neuritis. This case suggests common pathogenesis between central and peripheral demyelinating diseases.
Central Nervous System ; Cerebrospinal Fluid ; Demyelinating Diseases ; Encephalomyelitis, Acute Disseminated ; Evoked Potentials, Visual ; Humans ; Male ; Multiple Sclerosis ; Optic Neuritis* ; Peripheral Nervous System ; Visual Acuity ; Young Adult

Acute interstitial nephritis is a disorder that primarily affect the renal tubule and interstitium. This disease may result from a variety of cause but drug have emerged as the most common cause of acute interstitial nephritis. Characteristically, in acute interstitial nephritis mononuclear cell infiltrate the interstitium, particularly in cortex. Diagnosis of acute intersitital nephritis can be made from historical information, physical examination,or laboratory test. But renal biopsy is the most definitive method of diagnosis. Carbamazepine has been used as a drug for treatment of convulsive disorder. This drug cause rarely renal problem. The authors experienced a case of carbamazepine induced acute interstitial nephritis in a 20 years old man who showed skin rash and mild fever, deminished renal function, and who was diagnosed by history,physical examination, renal biopsy.
Acute Kidney Injury ; Biopsy ; Carbamazepine ; Diagnosis ; Exanthema ; Fever ; Humans ; Nephritis ; Nephritis, Interstitial* ; Young Adult

Recently, Prosthetic replacement of hip was recognized as a reliable technique for the treatment of avascular necrosis of femoral head in adult. There were many reports about post-operative evaluation of functional difference between hemiarthroplasty and total hip arthroplasty and which revealed that the revision rate for the total hip arthroplasty was less compared with the femoral endoprosthesis. Also, controversy was existed between the porous coating system and bone cement fixation. In order to evaluate the functional difference among each prosthetic replacement, authors reviewed the result of 10 cases of cementless unipolar endoprosthesis (abbreviated as UE), 10 cases of cementless bipolar endoprosthesis (abbreviated as BE), and 25 cases of cementless total hip replacement arthroplasy (abbreviated as THRA), performed at Department of Orthopaedic Surgery, Soon Chun Hyang University Hospital, during the period from September, 1985 to August, 1988. The following results were obtained: 1. The incidence was higher in 6th decade in UE, THRA groups, 4th decade in BE group. 2. The average follow up of UE, BE, and THRA groups were 30.7, 15.2, and 16.9 months, respectively. 3. By radiological classification of Marcus et al., the average stages of UE, BE, and THRA were 4.9, 4.0, and 5.3respectively. 4. According to Harris hip rating system, post-op. Harris scores were increased as much as 33.1, 37.2, and 43.4 in UE, BE, and THRA groups respectivelycompared with pre-op. score. 5. In this study, the last follow up results of hip function in BE, and THRA groups were better than that evaluated at 6 months after surgery in most cases. 6. External rotation, which was one of needed motion in cross leg sitting position, was significantly influenced by the degree of excision of joint capsule, the type of replacement prosthesis, the regimen of post-op. starting exercise, and a history of previous surgical treatment. 7. Because serious complications were not developed at recent follow up, the UE, BE, and THRA groups showed insignificant difference in functional difference in prosthetic replacement.
Adult ; Arthroplasty, Replacement ; Arthroplasty, Replacement, Hip ; Classification ; Follow-Up Studies ; Head ; Hemiarthroplasty ; Hip ; Humans ; Incidence ; Joint Capsule ; Leg ; Necrosis ; Prostheses and Implants

Apert's syndrome(acrocephalosyndactyly) is a rare congenital anomaly that is characterized by the combination of premature fusion of multiple cranial sutures primarily involving the coronal suture and severe symmetrical syndactyly of fingers and toes. Some patients of this syndrome have various abnormalities of the central nervous system. We experienced a case of Apert's syndrome with craniofacial malformations, symmetric syndactyly, occipital encephalocele and hypogenesis of corpus callosum. She had a oxycephalic head with small sized anterior fontanelle, elongated forehead, hypertelorism, down-slanting palpebral fissures, flattened nose, cleft palate, low set ears and short neck. A 5x3 cm sized scalp-covered soft mass protruded in the occipital area through defect of the occipital bone. MRI showed hypogenesis of corpus callosum, occipital encephalocele, dilatation of the lateral and the third ventricles. She also had hands and feet with symmetric syndactyly involved skin and soft tissue but not bones.
Central Nervous System ; Cleft Palate ; Corpus Callosum* ; Cranial Fontanelles ; Cranial Sutures ; Dilatation ; Ear ; Encephalocele* ; Fingers ; Foot ; Forehead ; Hand ; Head ; Humans ; Hypertelorism ; Magnetic Resonance Imaging ; Neck ; Nose ; Occipital Bone ; Skin ; Sutures ; Syndactyly ; Third Ventricle ; Toes