Subtrochsnteric varization osteotomy with open wedge technic was performed for the Legg-Calve-Perthes disease patients of 6 years to 9 years of age. Open wedge technic is less complicated with unwilling effect of postoperative leg shortening than closed wedge technic, but has seldom performed for the patients over 5 years of age because of possible delayed or nonunion of osteotomy site. Authors trial of this technic in a older patient(6 to 9 years of age) showed excellent post-operative result with noneventual post-operative course including delayed or nonunion.
Humans ; Leg ; Legg-Calve-Perthes Disease ; Osteotomy

BACKGROUND: A fully automated enzyme-immunoassay (EIA) analyzer, Enzymun System, ES-300 (Boehringer Mannheim, Germany) uses streptavidin technology and performs single test or panels of up to 12 tests per run. We evaluated the results of ES-300 for anti-HCV by comparing the results with microplate-EIA, radioimmunoassay (RIA), and confirmatory test. METHODS: Total 79 sera (51 positive, 24 negative, 4 indeterminate results confirmed by Lucky HCD Confirm) were analysed. ES-300 with Enzymun-Test(R) Anti-HCV (Boehringer Mannheim, Germany) and microplate-EIA (Green Cross Center Innotest HCV 3.0(R)) were used. Fifty one sera were examined additionally by 2nd-generation RIA method, NANBDINE 125C(General Biologicals Corp., R.O.C.). And all results were compared to the results of Lucky HCD Confirm. RESULTS: The overall concordance rate of ES-300 and Innotest(R) was 72/79 (91.1%). The results of Lucky HCD Confirm on seven discrepant samples were five negative and two indeterminate. The results of ES-300 and NANBDINE 125C showed concordance rate of 90.2%. The sensitivity and specificity of ES-300 with regard to Lucky HCD Confirm were 94.5%, and 87.5%, respectively, and that of Innotest(R) were 98.2% and 66.7%, respectively. Clear distinction of positive and negative results by signal/cut off ratio was available in both EIAs. The positive predictive values of ES-300 and Innotest(R) were 94.5%, and 87.1%, respectively. CONCLUSIONS: ES-300 showed relatively good results in sensitivity and positive predictive value with regard to confirmatory test. In EIA-positive persons, however, follow-up study would be necessary for reliable evaluation of HCV infection.
Humans ; Radioimmunoassay ; Sensitivity and Specificity ; Streptavidin

Turner's syndrome results from complete or partial monosomy of the X chromosome and is characterized by hypogonadism or related other congenital anomalies in phenotypic females. In these patients, there are failure to develop normal secondary sex characteristics, amenorrhea, or short stature at puberty and the ovaries are reduced to atrophic fibrous strands devoid of ova and follicles(streak gonads). Individuals with this condition are particularly prone to the development of gonadoblastoma. For this reason, the gonads should be early removed and supplemental estrogen therapy given. We experienced a case of Turner's syndrome, 45, XO/46, XY karyotype in a 20-year-old phenotypic female complained an amenorrhea. On the exploratory laparotomy, the right gonadal mass is sevearly adhered to the adjacent organs and measures 8 x 5 x 5 cm in dimension and 75gm in weight and shows multiple foci of hemorrhage with necrosis. The left streak gonad measures 3.5 x 2 x 1.5 cm in dimension and shows multiple foci of calcification. Microscopically, the right gonadal mass reveals malignant mixed germ cell tumor, composed of endodermal sinus tumor, composed of endodermal sinus tumor with dysgerminoma and gonadoblastoma. The left streak gonad consists of mainly dense fibrous connective tissue and shows some foci of calcification associated with gonadoblastoma. On immunohistochemical and special stainings, the cytoplasm and hyalin droplets of the endodermal sinus tumor component reveal strong positivity to the a-fetoprotein and PAS. After removal of both gonads, the serum level of the a-fetoprotein is markedly down from 1742ng/ml to 2.6 ng/ml.
Female ; Humans

No abstract available.
Humans ; Magnetic Resonance Imaging, Cine* ; Spinal Cord Diseases*

No abstract available.
Animals ; Neurons* ; Rats*

BACKGROUND: The prevalence of extended-spectrum -lactamase (ESBL)-producing Klebsiella pneumoniae and Escherichia coli has been increased in Korea, but the testing and reporting ESBL-mediated resistance remains unclear. We undertook a study to evaluate the method to screen isolates of ESBL-producing K. pneumoniae and E. coli using cefpodoxime disk. METHODS: Fifty-eight strains of K. pneumoniae and 28 strains of E. coli were tested for production of ESBLs by the double disk synergy test. Susceptibility to cefpodoxime, ceftazidime, cefotaxime, and aztreonam was determined by disk diffusion method. RESULTS: All strains that produced ESBLs were resistant to cefpodoxime, whereas those that not produced ESBLs were susceptible (97%) to this agents. The disk diffusion test exhibited 100% sensitivity and 97% specificity when NCCLS conventional interpretive criteria were used. All other oxyimino- -lactam agents tested were inferior discriminators between the two groups of organisms. When NCCLS ESBL interpretive criteria were used, the disk diffusion test using cefpodoxime exhibited 100% sensitivity and 83% specificity. CONCLUSIONS: Routine disk diffusion susceptibility test with cefpodoxime disk (10g) can be used to detect strains of ESBL-producing K. pneumoniae and E. coli without include supplemental testing for ESBL production.
Aztreonam ; Cefotaxime ; Ceftazidime ; Diffusion ; Escherichia coli* ; Escherichia* ; Klebsiella pneumoniae* ; Klebsiella* ; Korea ; Pneumonia ; Prevalence ; Sensitivity and Specificity

BACKGROUND: Viral isolation in cell culture remains as a reference method for diagnosis of enteroviral infection. Enteric adenoviruses are cultivated in 293 cells. Enteroviral and enteroadenovrial tropisms for the gastrointestinal tract lead to the assumption that 293 cells would be useful in enteroviral isolation. We evaluated usefulness of 293 cells in the diagnosis of enteroviral infection. METHODS: Human embryonic lung fibroblasts (HEL), HeLa, RD and 293 cells were used to evaluate viral isolation from clinical specimens, susceptibilities of the cell lines to reference enteroviral strains and influence to stool extracts on the viral isolation. Forty-four stool specimens collected from patients during the epidemic period of type 9 echoviral aseptic meningitis and type 30 echoviral culture-positive 33 stool and 58 cerebrospinal fluid (CSF) specimens were inoculated onto cell lines. RESULTS: Echovirus type 9 was isolated from 31 of 44 stool specimens. Of 31 echovirus 9 isolates, 22 (71.0%), 21 (67.7%), 6 (19.4%) and 3 (9.7%) were detected in HEL, 293, RD and HeLa, respectively. Of 33 echovirus 30 isolates from stool specimens, 32 (97.0%) were detected in 293; 17 (51.5%) were detected in RD. Of 58 echovirus 30 isolates from CSF specimens, 39 (67.2%) were detected in 293; 30 (51.7%) were detected in RD. 293 cells were sensitive for coxsackievirus A9 reference strain and echovirus 7 reference strain. Stool extracts induced enhanced cytopathic effect by echovirus 9 infection in 293 and HEL. CONCLUSIONS: 293 cells are useful in the diagnosis of echoviral and some enteroviral infection.
Adenoviridae ; Cell Culture Techniques ; Cell Line ; Cerebrospinal Fluid ; Diagnosis ; Echovirus 9 ; Enterovirus B, Human ; Enterovirus* ; Fibroblasts ; Gastrointestinal Tract ; Humans ; Lung ; Meningitis, Aseptic ; Tropism

BACKGROUND: Respiratory syncytial virus (RSV) is the single most common cause of lower respiratory tract infections in infants and young children. RSV can be classified into two major groups, A and B with subgroups based on their reactivity with monoclonal antibodies. There were no reports on the subgroups of RSV isolates in Korea. The purpose of this study is to identify RSV isolates from patients with lower respiratory tract infections to subgroup level and to examine clinical characteristics of subgroup infections. METHODS: RSV infection was diagnosed by viral culture of nasopharyngeal aspirates in patients with lower respiratory infection. Forty two RSV isolates over four successive outbreaks (94/95, November 1994-January 1995; 95/96, Nov. 95-Jan. 96; 96/97, Nov. 96-Jan. 97; 97/98, Nov. 97-Jan. 98) were subgrouped by indirect immunofluorescence with subgroup-specific monoclonal antibodies. Clinical characteristics of subgroup infections were evaluated by review of medical records. RESULTS: Twenty eight (67%) isolates were identified as group A and 14 (37%) strains as group B. Group A isolates of the 94/95, 95/96, and 96/97 seasons were subgroup A/4, and those of 97/98 season were subgroup A/2. Group B isolates were all identified as subgroup B/2. There was no statistically significant difference in clinical characteristics according to the subgroup infections. CONCLUSIONS: This study show that RSV subgroup A/4, A/2 and B/2 isolated over recent four successive epidemic seasons in Seoul. There was no significant difference in clinical characteristics or severity according to the subgroup infections.
Antibodies, Monoclonal ; Child ; Disease Outbreaks ; Fluorescent Antibody Technique, Indirect ; Humans ; Infant ; Korea ; Medical Records ; Respiratory Syncytial Viruses* ; Respiratory Tract Infections ; Seasons ; Seoul

PURPOSE: Intravesical instillation of bacillus Calmette-Guerin(BCG) is an established and effective therapy for the superficial bladder carcinoma. The viability of BCG is crucial for the induction of a local immune response as well as effective therapy of recurrent superfical bladder carcinoma. Lubricants are used to facilitate catheterization during intravesical instillation of BCG. Moreover bacteriostatic components contained in them have potential to reduce the viability of the BCG. To verify this assumption, inhibitory effect of four commercially available lubricants on the BCG growth was analyzed. MATERIALS AND METHOD: Four different lubricants and their components were co-incubated with Connaught strain BCG and the resultant growth of BCG was assessed. RESULTS: Significant impairment of BCG viability with lubricants was noted. Chlorhexidine digluconate which is the component of lubricant was considered as responsible for this inhibition. CONCLUSIONS: During intravesical BCG, lubricants might reduce the number of viable BCG in clinical use. For this reason, during intravesical immunotherapy with BCG small amounts of lubricants should be used for urethral catheterization and use of lubricant which does not contain bacteriostatic agent should be considered.
Administration, Intravesical ; Bacillus* ; Catheterization ; Catheters ; Chlorhexidine ; Immunotherapy ; Lubricants ; Mycobacterium bovis ; Thiram ; Urinary Bladder ; Urinary Catheterization ; Urinary Catheters

BACKGROUND: Staphylococcus aureus is most frequently isolated Gram-positive cocci from clinical specimens. The accurate identification of S. aureus is required. Lipovitellin-salt-mannitol (LSM) agar is medium for differentiating S. aureus and coagulase-negative staphylococci (CNS) by mannitol acidification and lipovitellin lipase reaction. In this study, we compare LSM agar with the other conventional methods for differentiating S. aureus and CNS in clinical laboratories, coagulase test, mannitol-salt agar (MSA), and DNase agar. METHODS: One hundred and forty-five isolates of staphylococci from clinical specimens are used. S. aureus and CNS were identified by coagulase test, MSA, DNase agar, and LSM agar. RESULTS: Eighty-nine isolates were identified as S. aureus and 59 isolates were revealed CNS. Compared ability of methods to differntiate S. aureus from CNS, sensitivity and specificity were 98.7% and 96.6% with LSM agar, 92.1% and 96.6% with coagulase test, 96.6% and 93.2% with MSA, 93.3% and 98.3% with DNase agar, respectively. CONCLUSIONS: LSM agar show good discrimination between S. aureus and CNS. LSM agar may be used for identification of S. aureus in clinical laboratories.
Agar* ; Coagulase ; Deoxyribonucleases ; Discrimination (Psychology) ; Gram-Positive Cocci ; Lipase ; Mannitol ; Sensitivity and Specificity ; Staphylococcus aureus* ; Staphylococcus*