This study was performed in order to evaluate the sero-epidemiological status of toxoplasmosis in pregnant Korean women. Among 5, 175 sera and 750 amniotic fluid samples obtained from pregnant women, 41 serum samples (0.79%) and 10 (1.33%) amniotic fluid samples tested positive for IgG antibodies by ELISA. Fifty one cases showing a score more than 0.25 on ELISA were tested for PCR reaction against the SAG1 gene. Only one case of the 51 ELISA positive cases exhibited a positive reaction on all tests. This case had a history of acute nephropyelitis during early pregnancy, but fortunately, had delivered a phenotypically healthy baby. In this study, the seroprevalence of toxoplasmosis in pregnant women was found to be comparatively low, consistent with previous reports from Korea. However our trials, performed with a variety of diagnostic tools, were considered to be useful for the precise diagnosis of congenital toxoplasmosis.
Adult ; Animals ; Antibodies, Protozoan/*blood ; Female ; Humans ; Korea/epidemiology ; Pregnancy ; Pregnancy Complications/diet therapy/*epidemiology ; Seroepidemiologic Studies ; Toxoplasma/*immunology ; Toxoplasmosis/*epidemiology

BACKGROUND: Compared with conventional routes of delivering potent analgesics to postoperative patients, transdermal administration of fentanyl offers the advantages of simplicity and noninvasiveness. The analgesic efficacy and safty of transdermal fentanyl patch (TDFP) were evaluated postoperatively. METHOD: TDFP releasing 25 mcg/hr (Group 1) or placebo (Group 2) were applied to 40 women 6 hours before total abdominal hysterectomy under the general anesthesia. Postoperatively, self-administered intravenous fentanyl was maintained with a 20-mcg incremental dose and a 10-min. locking interval. Each group was assessed following 48 hours with respects to vital signs, VAS pain scores, hourly-used fentanyl doses, satisfaction scores and side effects. RESULT: VAS observed 24 hours, 36 hours after operation were significantly lower in group 1 than group 2. Hourly-used fentanyl doses were significantly lower in group 1 than group 2 at 2 hours, 6 hours, 12 hours and 24 hours after operation. The incidence of side effects were similar between group 1 and group 2. CONCLUSION: TDFP-25 mcg applied 6 hours before operation provides supplementary analges-ia after the postoperative period without significant side effects such as respiratory depression.
Administration, Cutaneous ; Analgesics ; Anesthesia, General ; Female ; Fentanyl* ; Humans ; Hysterectomy* ; Incidence ; Postoperative Period ; Respiratory Insufficiency ; Vital Signs

BACKGROUND: It has been suggested that human papillomavirua(HPV) infection has been implicated in the pathogenesis of between disease and squamous cell cacoma of the skin, particularly of snogenital area. There is little knowledge about etiologic characteriscs of the development of Bowens disease and squamous cell earcinoma of the skin in Korean patients. OBJECTIVE: This study is intended to evaluate Bowens disease and squamous cell carcinoma of the skin in Korean patients for the presence of HPV. METHODS: Fifteen cases of Bowens disease and fifteen cases of cutaneous squamous cell carcinoma were investigated. All cases developed on a nongenital site. In situ lybridization and polymerase chain reaction(PCR) were used for detection of HPV DNA in paraffinem bedded tissue sections. The clinical records and slides of these cases were reviewed for the analysis of clinicopathologic characteristiqs of HPV DNA positive eases. RESULTS: By in situ hybidization HPV 16 was detected in thrw cases(20%) with Bowens disease. By PCR HPV 16 was detected in six cases(40% ) of Bowens digreae and five cases(33.3) of squamous cell carcinoma of the skin. No specific clinicopathologic fetetues were found to be indicative of the presence or absence of HPV. CONCLUSION: These data suggest a role for HPV in the evolution of Bowens disease and squamous cell carcinoms of the skin in Korean patients.
Bowen's Disease ; Carcinoma, Squamous Cell* ; DNA* ; Human papillomavirus 16 ; Humans* ; Polymerase Chain Reaction ; Skin*

The scanty literature on distal tibiofibular synostosis includes descriptions of relatively few specific complaints. Here we report a case of a 24-year-old young soldier who sustained a left ankle lateral malleolar fracture about 6 months ago and was initially treated by the open reduction and internal fixation with plate & screw. But 6 months later, he suffered from an vague ankle pain, each time the symptoms occurred right after an active ambulation, ankle dorsiflexion, especially when he had exercised aggressively. The radiographs revealed that there was a mature distal tibiofibular synostosis. We treated the patient with surgical excision of synostosis. Post-operative condition was satisfied to all concern and the result was found to be excellent during one-year follow-up.
Animals ; Ankle ; Follow-Up Studies ; Humans ; Military Personnel ; Synostosis ; Walking ; Young Adult

Eighty-three cases with severe blepharoptosis were treated by the superiorly based muscle flaps around eye including orbicularis oculi muscle, frontalis muscle, levator muscle. The selection of the muscle flaps were done in accordance with the levator function of patients. The orbicularis oculi muscle flap technique in 32 patients who have 2-5 mm levator function, 21 cases of the interdigitated orbicularis oculi-frontalis muscle flap for 1-3 mm levator function, frontalis muscle flap technique for less than 2 mm levator function, 22 cases of levator muscle resection for 2-8 mm levator function, 7 cases of levator plication for 5-9 mm levator function. The majority of patients recorded as satisfactory results. There has been no complete failure but there were 14 cases of undercorrection, 4 cases of overcorrection, 2 cases of exposure keratitis, 3 cases of corneal erosion, 2 cases of sensory loss, hematoma loss of wrinkle and a few cases of eyelid deformity such as notching, entropion, fading or unnatural fold. The orbicularis oculi muscle technique or the interdigitated orbicularis oculi-frontalis muscle flap technique offers several advantages over conventional frontalis muscle flap technique such as being a simple with a good operative field, single incision or supratarsal fold, no depression on the forehead, no risk of neurovascular injury and relatively easy technique with less complication. The levator resection or levator plication could offer good results by careful selection of patients. In conclusion, we would like to say that the interdigitated frontalis orbicularis oculi muscle flap technique is best in cases with less than 2 mm levator function, orbicularis oculi muscle flap technique in 2-4 mm levator function, levator resection in 4-8 mm levator function, levator plication in more that 8 mm levator function.
Blepharoptosis* ; Congenital Abnormalities ; Depression ; Entropion ; Eyelids ; Forehead ; Hematoma ; Humans ; Keratitis

The nfa1 gene was cloned from a cDNA library of pathogenic Naegleria fowleri by immunoscreening; it consisted of 360 bp and produced a 13.1 kDa recombinant protein (rNfa1) that showed the pseudopodia-specific localization by immunocytochemistry in the previous study. Based on the idea that the pseudopodia-specific Nfa1 protein mentioned above seems to be involved in the pathogenicity of N. fowleri, we observed the effect of an anti-Nfa1 antibody on the proliferation of N. fowleri trophozoites and the cytotoxicity of N. fowleri trophozoites on the target cells. The proliferation of N. fowleri trophozoites was inhibited after being treated with an anti-Nfa1 polyclonal antibody in a dose-dependent manner for 48 hrs. By a light microscope, CHO cells co-cultured with N. fowleri trophozoites (group I) for 48 hrs showed severe morphological destruction. On the contrary, CHO cells co-cultured with N. fowleri trophozoites and anti-Nfa1 polyclonal antibody (1: 100 dilution) (group II) showed less destruction. In the LDH release assay results, group I showed 50.6% cytotoxicity, and group II showed 39.3%. Consequently, addition of an anti-Nfa1 polyclonal antibody produced a decreasing effect of in vitro cytotoxicity of N. fowleri in a dosedependent manner.
Animals ; Antibodies, Protozoan/*immunology ; Antigens, Protozoan/genetics/*immunology ; CHO Cells ; Dose-Response Relationship, Immunologic ; Female ; Hamsters ; Mice ; Mice, Inbred BALB C ; Naegleria fowleri/growth & development/immunology/*pathogenicity ; Protozoan Proteins/genetics/*immunology ; Recombinant Proteins/immunology ; Support, Non-U.S. Gov't

PURPOSE: The purpose of this study was to analyze the results of treating subtrochanteric femoral fractures with proximal femoral nail antirotation (PFNA). MATERIALS AND METHODS: Twenty five consecutive patients diagnosed with subtrochanteric femoral fractures underwent intramedullary fixation using PFNA and followed-up for over 12 months. According to the Seinsheimer's classification, there were 2 type IIA, 9 type IIB, 2 type IIIA, 3 type IV and 9 type V. According to the AO classification, there were 10 type A, 9 type B and 6 type C. There were 16 cases of closed reduction group and 9 cases of limited open reduction group. Retrospectively, radiological outcomes were assessed at the union period, change of neck shaft angle, tip-apex distance, Cleveland index, sliding of lag screw and complication. RESULTS: Union was achieved in 23 of 25 cases, over an average of 17 weeks. Limb length shortening below 2 cm occurred in 7 patients. The Cleveland index was shown in 80% of 5, 6, 8 and 9 zone; the tip apex distance was 19.6 mm; the mean sliding distance was 4.4 mm; and the mean change of femur neck and shaft angle was varus 3 degree at the final follow-up. Complications included 3 cases of delayed union and 2 cases of nonunion. CONCLUSION: With its early bony union, ambulation, rehabilitation and low complication, PFNA is a useful and reliable choice for the treatment of subtrochanteric fractures of the femur. Limited open reduction and additional fixation such as cable grip are recommended if it is difficult to obtain anatomical reduction by closed reduction.
Extremities ; Femoral Fractures ; Femur ; Femur Neck ; Follow-Up Studies ; Hand Strength ; Hip Fractures* ; Humans ; Retrospective Studies ; Walking

Protective efficacy of vaccination with Neospora caninum multiple recombinant antigens against N. caninum infection was evaluated in vitro and in vivo. Two major immunodominant surface antigens (NcSAG1 and NcSRS2) and two dense granule proteins (NcDG1 and NcDG2) of N. caninum tachyzoites were expressed in E. coli, respectively. An in vitro neutralization assay using polyclonal antisera raised against each recombinant antigen showed inhibitory effects on the invasion of N. caninum tachyzoites into host cells. Separate groups of gerbils were immunized with the purified recombinant proteins singly or in combinations and animals were then challenged with N. caninum. Following these experimental challenges, the protective efficacy of each vaccination was determined by assessing animal survival rate. All experimental groups showed protective effects of different degrees against experimental infection. The highest protection efficacy was observed for combined vaccination with NcSRS2 and NcDG1. Our results indicate that combined vaccination with the N. caninum recombinant antigens, NcSRS2 and NcDG1, induces the highest protective effect against N. caninum infection in vitro and in vivo.
Animals ; Antibodies, Protozoan/immunology ; Antigens, Protozoan/immunology ; Cercopithecus aethiops ; Coccidiosis/prevention & control ; Dose-Response Relationship, Immunologic ; Gene Expression ; Gerbillinae ; Neospora/*immunology ; Protozoan Vaccines/*immunology ; Research Support, Non-U.S. Gov't ; Vaccines, Synthetic/immunology ; Vero Cells

Retrospective analysis of 46 patients with intracerebral hematoma showed that the attack was most frequent in sixth decade and more prevalent in female. The most common cause of the attack was hypertension(80%) and the site of hemorrhage was putamen 32%, thalamic area 15%, subcortical area 7%, cerebellum 17%, ventricle 3%, and brain stem 4%. Mortality of total cases was 36% and there was no difference of mortality in both conservatively or operatively treated group(38% in conservative group, and 35% in operative group). The prognosis of the patient was unfavorable in the group of poor pretreatment Glasgow coma scale(GCS) and those of cases demonstrated more than 30cc of hematoma on computerized tomography(CT) of the brain. The improvement of GCS after management was better in operative group than in the conservative group.
Brain ; Brain Stem ; Cerebellum ; Coma ; Female ; Hematoma* ; Hemorrhage ; Humans ; Hypertension ; Mortality ; Prognosis ; Putamen ; Retrospective Studies

OBJECTIVE: The purpose of this study was to evaluate the different patterns of bone loss between the lumbar spine and the femur after ovariectomy in rats. METHODS: Twenty-four female Sprague-Dawley rats underwent a sham operation (the sham group) or bilateral ovariectomy (the ovariectomized group). Four and eight weeks after operation, six rats from each of the two groups were euthanized. Serum biochemical markers of bone turnover including osteocalcin and alkaline phosphatase (ALP), which are sensitive biochemical markers of bone formation, and the telopeptide fragment of type I collagen C-terminus (CTX), which is a sensitive biochemical marker of bone resorption, were analyzed. Bone histomorphometric parameters of the 4th lumbar vertebrae and femur were determined by micro-computed tomography. RESULTS: Ovariectomized rats were found to have higher osteocalcin, ALP and CTX levels than sham controls. Additionally, 8 weeks after ovariectomy in the OVX group, serum levels of osteocalcin, ALP and CTX were significantly higher than those of 4 weeks after ovariectomy. Bone loss after ovariectomy was more extensive in the 4th lumbar spine compared to the femur. Bone loss in the 4th lumbar spine was mainly caused by trabecular thinning, but in the femur, it was mainly caused by trabecular elimination. CONCLUSION: The present study demonstrates different patterns of bone loss between the 4th lumbar spine and the femur in ovariectomized rats. Therefore, when considering animal models of osteoporosis, it is important that bone sites should be taken into account.
Alkaline Phosphatase ; Animals ; Biomarkers ; Bone Resorption ; Collagen Type I ; Female ; Femur ; Humans ; Lumbar Vertebrae ; Models, Animal ; Osteocalcin ; Osteogenesis ; Osteoporosis ; Ovariectomy ; Rats ; Rats, Sprague-Dawley ; Salicylamides ; Spine