BACKGROUND: Tuberculosis continues to be a major threat to health throughout the world, with an estimated 8 to 10 million new cases and 3 million deaths annually. And control of the disease is further threatened by the emergence of drug resistance. Recent major advances have been made in unravelling the molecular basis of M. tuberculosis resistance to isoniazid, streptomycin, quinolones and rifampin. And rifampin resistance is the useful indicator for the occurance of the multi-drug resistance. Hence, the rapid detection of rifampin resistant strain of M. tuberculosis is the key to have successful anti-tuberculosis therapy. Here we present our experience using PCR and line probe assay (INNO-LiPA) for easy and rapid detection of rifampin resistance of M. tuberculosis. METHODS: Thirty rifampin resistant and twenty susceptible strains of M. tuberculosis were collected from the routine culture and analyzed with INNO-LiPA. And results were compared with conventional antibiotic susceptibility testing. After amplification of the region of the RNA polymerase(rpoB), the amplified product is hybridized with a set of 10 oligonucleotides immobilized onto a membrane strip. From the pattern obtained the presence or not of rifampin resistance M. tuberculosis can be assessed. RESULTS: Ninety three percent of patients who had rifampin resistant strain revealed the multidrug resistance while only two showed resistance to rifampin only. The INNO-LiPA test results were generally agreeable with that of the conventional susceptibility testing(90%). The mutations in codon 531 (absence of 55 probe) were most commonly observed. In 55.2% of the 31 rifampin resistance M. tuberculosis confirmed on mutation by R-probes on the INNO-LiPA strips. CONCLUSIONS: The line probe assay after polymerase chain reaction is a fast and convenient method to detect both presence of M. tuberculosis complex strains and its resistance to rifampin in clinical specimens. We have suggested that detection of rifampin resistance may play a key role in monitoring multi-drug resistance. Consequently, the INNO-LiPA test may constitute an important tool for the control of tuberculosis.
Codon ; Drug Resistance ; Drug Resistance, Multiple ; Humans ; Isoniazid ; Membranes ; Mycobacterium tuberculosis* ; Mycobacterium* ; Oligonucleotides ; Polymerase Chain Reaction ; Quinolones ; Rifampin* ; RNA ; Streptomycin ; Tuberculosis

Angiogenesis is essential for tumor growth and metastasis, however, the prognostic value of neovascularization is undetermined. The aim of this study is to evaluate the prognostic significance of microvessel density (MVD) and vascular endothelial growth factor (VEGF) expression in breast carcinomas. An immunohistochemical stains for CD 31 (DAKO) to estimate MVD and VEGF (Santa Cruz) were done on 40 cases of invasive breast carcinoma. MVD was calculated as an average count of vessels per 200 power field in the most vascularized areas. VEGF expression was interpreted according to staining intensity and number of positive cells. Mean MVD was 35, and MVD was not correlated with lymph node metastasis or histologic grade, but high MVD (mean MVD>35) showed an increasing tendency in cases with larger size, negative ER/PR, and positive cathepsin D. All of the cases showed VEGF expression, but VEGF expression was not correlated with tumor size, histologic grade, lymph node metastasis, ER/PR status, and cathepsin D expression. These results suggest that MVD and VEGF expressions are not reliable prognostic factors.
Breast Neoplasms* ; Breast* ; Cathepsin D ; Coloring Agents ; Lymph Nodes ; Microvessels* ; Neoplasm Metastasis ; Vascular Endothelial Growth Factor A*

PURPOSE: The study aimed to determine the impact of post-traumatic stress and ways of stress coping on problem drinking in firefighters. METHODS: Data were collected from May 11 to June 11, 2015, in fire brigades across South Korea. Participants were 183 male firefighters who used self-report questionnaires containing questions from the Impact of Event Scale-Revised (IES-R), Ways of Coping Checklist (WCC), and Alcohol Use Disorders Identification Test (AUDIT). Data were analyzed using χ2 test, t-test, and logistic regression with the SPSS/WIN 21.0 program. RESULTS: The prevalence of PTSD among firefighters was 36.7% and that of problem drinking was 39.3%. Firefighters with single (OR=0.23, 95% CI=0.038~1.321) and married status (OR=0.46, 95% CI=0.069~3.040) were less likely to have problem drinking than those who were divorced or bereavement. Those with invasion symptoms (OR=1.17, 95% CI=1.031~1.327) and hyperarousal symptoms (OR=0.85, 95% CI=0.722~0.989) were more likely to have problem drinking than those with avoidance symptoms. CONCLUSION: Post-traumatic stress symptom was a major risk factor that increased problem drinking, and married status reduced problem drinking. There is a need to develop post-traumatic stress symptom management program and early education content for symptom management.
Bereavement ; Checklist ; Divorce ; Drinking* ; Education ; Firefighters* ; Fires ; Humans ; Korea ; Logistic Models ; Male ; Prevalence ; Risk Factors ; Stress Disorders, Post-Traumatic

BACKGROUND: Ischemic heart disease and cerebrovascular disease are the main causes of death and platelets are responsible for the formation of arterial thrombi. Platelet membrane glycoproteins (GP) associated with coagulation pathway are GPIb/V/IX, GPIa/IIa, and GPIIb/IIIa. We evaluated genotype and allele frequencies of seven platelet glycoprotein genes associated with arterial thrombosis. METHODS: Genomic DNA was isolated from peripheral blood of 300 unrelated Korean and single nucleotide polymorphism of platelet glycoproteins was analyzed. PCR with sequence specific primers was used to investigate GPIa C807T and GPIbalpha VNTR polymorphism. PCR-RFLP (restriction fragment length polymorphism) was used to investigate GPIa G1648A and C2531T, GPIbalpha C524T and T-5C, and GPIIIa T1565C polymorphism. RESULTS: The allele frequencies of GPIa C807T were 807C 0.733, 807T 0.267; GPIa 1648G 0.975, 1648A 0.025; GPIa C2531T, 2531C 1.000, 2531T 0.000; GPIbalpha C524T, 524C 0.927, 524T 0.073; GPIbalpha VNTR, A 0.017, B 0.015, C 0.558, D 0.410; GPIbalpha T-5C, -5T 0.726, -5C 0.274; GPIIIa T1565C, 1565T 0.995, 1565C 0.005. CONCLUSION: The genotype and allele frequencies of GPIa G1648A, GPIbalpha C524T, and GPIIIa T1565C were similar to established data. GPIa 807T and -5T allele of Kozak polymorphism showed low frequency compared with other ethnic group. Allele frequencies of GPIbalpha VNTR A and B alleles were very alike (0.017 vs 0.015). In this study, we firstly evaluated the genotype and allele frequencies of GPIa C2531T and GPIbalpha VNTR, T-5C polymorphisms in Korean population. This study will serve as a basic data for the study of platelet glycoproteins associated with arterial thrombosis in Korean.
Alleles* ; Blood Platelets* ; Cause of Death ; DNA ; Ethnic Groups ; Gene Frequency* ; Genotype* ; Glycoproteins* ; Humans ; Integrin alpha2 ; Integrin beta3 ; Myocardial Ischemia ; Platelet Membrane Glycoproteins ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; Thrombosis*

PURPOSE: To evaluate the findings and role of contrast-enhanced fat suppression MR imaging in avascular necrosis(AVN) of the femoral head. MATERIALS AND METHODS: In 15 patients with AVN of the femoral head, MR T1-weighted and T2-weighted images and contrast-enhanced fat-suppression T1-weighted images were obtained, and the findings were re-viewed. Early and advanced groups were classified on the basis of clinical findings and imaging, and the en-hancement pattern was classified as either type I, rim enhancement; type II, surrounding diffuse enhance-ment; type III, intralesional enhancement; or type IV, II + III. RESULTS: Twenty-four cases of AVN of the femoral head were detected; in nine patients, lesions were bilateral. Eight cases occurred in the early group and 16 in the advanced. All eight in the early group showed the "double line sign" on T2-weighted images, with a type-I enhancement pattern. In the advanced goup, type II(8/16) and type IV(8/16) enhancement patterns were seen. Among the cases showing the type-IV pattern, the intrale-sional enhancing area showed low signal intensity on T1-weighted images and isosignal intensity on T2 weighted in one case, and low signal intensity on T1-weighted images and high signal intensity on T2-weight-ed in the other cases. There was no difference in the extent of the disease before and after enhancement. CONCLUSION: Contrast-enhanced fat-suppression MR images may be helpful in evaluating the extent of AVN of the femoral head and predicting the histopathologic findings of the disease
Head* ; Humans ; Magnetic Resonance Imaging* ; Necrosis*

OBJECTIVE: To evaluate the result of the human papillomavirus (HPV) DNA polymerase chain reaction (PCR) in comparison with cervical cytology for the detection of cervical intraepithelial neoplasia (CIN) and invasive cancer, and to establish the more economic and effective screening method for CIN and invasive cancer. METHODS: HPV DNA PCR test and cervical cytology were applied to 476 women, who were referred for abnormal cytology from April 2004 to March 2005 at National Health Insurance Corporation Ilsan Hospital. The results of both procedures were compared with the results of the histological diagnosis and we calculated and compared the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of cytology, HPV DNA PCR, and their combination, respectively. RESULTS: The sensitivity, specificity, PPV and NPV for the detection of CIN or higher lesion were 98.3%, 64.4%, 82.4%, and 95.7% for HPV DNA PCR; 82.9%, 72.9%, 83.8% and 71.7% for cytology; 100%, 48.6%, 76.7%, and 100% for the combination test. The sensitivity and NPV value of cytology showed statistically significant differences (p<0.05) compared with those of HPV PCR and combination test. The PPV value of combination test showed statistically significant difference compared with those of cytology and HPV PCR. The specificity of three tests were alike (p>0.05). The sensitivity of three tests for the detection of CIN 2, 3 or higher lesion showed no statistically significant differences. CONCLUSION: The routine application of HPV DNA PCR or combination test as a screening tools for the detection of CIN and invasive cancer seems to be inappropriate in view of effectiveness. But the HPV DNA PCR can be used as a valuable adjunct to cervical cytology for the triage of women with minimal abnormality in her cytology to determine the treatment and follow-up plan.
Cervical Intraepithelial Neoplasia* ; Diagnosis ; DNA* ; Female ; Humans* ; Mass Screening* ; National Health Programs ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Triage

OBJECTIVE: The surgical clipping of paraclinoid segment internal carotid artery aneurysms is considered difficult because of the complex anatomical location and important neighboring structures. Our experiences of pterional craniotomy and extradural anterior clinoidectomy (EAC) to clip paraclinoid aneurysms are reported herein. METHODS: We present two patients with paraclinoid aneurysms who underwent surgical clipping using pterional craniotomy and EAC. The clinical results and operative techniques were reviewed from the patients' medical records. RESULTS: EAC improves the surgical field in the suprasellar and periclinoid regions. Clinically, a good outcome was obtained in both cases. No surgical complications directly resulting from the EAC were observed. CONCLUSION: Favorable surgical results can be obtained with pterional craniotomy and EAC for the clipping of paraclinoid aneurysms. EAC is advocated for the clipping of paraclinoid aneurysms.
Aminocaproic Acids ; Aneurysm ; Carotid Artery, Internal ; Craniotomy ; Humans ; Surgical Instruments

PURPOSE: The purpose of this study was to identify the complex course of the mandibular canal using 3D reconstruction of microCT images and to provide the diagram for clinicians to help them understand at the interforaminal region in Korean. MATERIALS AND METHODS: Twenty-six hemimandibles obtained from cadavers were examined using microCT, and the images were reconstructed. At both the midpoint of mental foramen and the tip of anterior loop, the bucco-lingual position, the height from the mandibular inferior border, the horizontal distance between two points, and position relative to tooth site on the mandibular canal were measured. The angle that the mental canal diverges from the mandibular canal was measured in posteriorsuperior and lateral-superior direction. RESULTS: The buccal distance from the mandibular canal was significantly much shorter than lingual distance at both the mental foramen and the tip of anterior loop. The mandibular canal at the tip of anterior loop was significantly located closer to buccal side and higher than at the mental foramen. And the mental canal most commonly diverged from the mandibular canal below the first premolar by approximately 50° posterior-superior and 41° lateral-superior direction, which had with a mean length of 5.19 mm in front of the mental foramen, and exited to the mental foramen below the second premolar. CONCLUSION: These results suggest that it could form a hazardous tetrahedron space at the interforaminal region, thus, the clinician need to pay attention to the width of a premolar tooth from the mental foramen during dental implant placement.
Bicuspid ; Cadaver ; Dental Implants ; Tooth ; X-Ray Microtomography

BACKGROUND: InBody 4.0, a bioelectrical impedance analyser (BIA) has an automatic function of printing out the measurement data of visceral fat area. The purpose of this study was to assess the usefulness of the visceral obesity measured by the InBody 4.0 and the waist circumference METHODS: A total of 124 participants who visited an obesity clinic in a university hospital were measured their waist circumference, height, weight and the visceral fat area by the InBody 4.0 and CT scan. The mean difference and agreement between the two visceral fat areas by the two methods had been analyzed according to sex, age and BMI groups. The accuracy of the visceral obesity by the BIA and the waist circumference was respectively compared with the visceral obesity by the CT scan. RESULTS: There was no significant difference between visceral fat area measured by the CT and the BIA in women participants under 46 years of age and below BMI 30. When comparing visceral fat area obtained from the CT with those obtained from the BIA, the 95% confidence interval for the limit agreement was higher in male subjects than in females. The waist circumference was the more sensitive method to diagnose visceral obesity than the BIA (91.80% vs. 77.94%), but the BIA method showed a higher specificity than the waist circumference (76.79% vs 52.38%). CONCLUSION: Waist circumference turned out to be more useful than the BIA as a screening tool for visceral obesity. In the group of males, BMI of over 30, or the age over 46 years, it is recommended that the CT rather than the BIA for measurement of visceral fat area be utiliged.
Electric Impedance ; Female ; Humans ; Intra-Abdominal Fat ; Male ; Mass Screening ; Obesity ; Obesity, Abdominal* ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Waist Circumference*

The Truncus arteriosus is a congenital malformation in which only one great artery arises from the base of the heart and gives origin to the systemic, pulmonary and coronary arteries proximal to the aortic arch. Pulmonary blood flow is governed by the size of the pulmonary arteries and the pulmonary vascular resistance. In infancy, pulmonary blood flow is usually excessive because pulmonary vascular resistance is not greatly increased. Thus, despite an obligatory admixture of systemic and pulmonary venous blood in the common trunk, only minimal cyanosis is present. Rarely pulmonary blood blood flow is restricted by hypoplastic or stenotic pulmonary arteries arising from the truncus. The prognosis in persistent truncus arteriosus is very poor. the median age of survival of the 94 patients with the disease reported up to 1962 was only five weeks. The longest survival reported is the case of the man described by Carr et al who lived to the age of 36 years and 2 months. We report the case of a man with persistent truncus arteriosus who lives to the age of 29 years.
Aorta, Thoracic ; Arteries ; Coronary Vessels ; Cyanosis ; Heart ; Humans ; Prognosis ; Pulmonary Artery ; Truncus Arteriosus ; Truncus Arteriosus, Persistent* ; Vascular Resistance