In spite of the extensive use of antibiotics over several decades, Streptococcus pneumoniae still remains as one of the most serious human bacterial pathogens. In order to clone the pneumococcal genes whose expression is induced when pneumococcus causes infection in mice, S. pneumoniae strain ATCC 6303 was subcultured on blood agar plates (BAP) ten times to reduce the virulence first, and then passaged through BALB/c mice three times to restore the virulence. Subtractive hybridization was performed using the total RNA preparations isolated from BAP-cultured and mouse-passaged strains. Complementary DNAs corresponding to any mRNA species that were differentially expressed in the mouse- passaged strain were used as the probes to screen the genomic library of pneumococcus. Positive recombinants were selected and sequenced partially to identify the genes located within the cloned DNA. GenBank search of the sequence data has identified several genes including two heat shock genes (dnaK and dnap, a transposase-encoding gene, and a sequence which is very homologous to that of the ftsH gene.
Agar ; Animals ; Anti-Bacterial Agents ; Clone Cells* ; Cloning, Organism* ; Databases, Nucleic Acid ; DNA ; DNA, Complementary ; Genomic Library ; Hot Temperature ; Humans ; Mice ; Pneumonia ; RNA ; RNA, Messenger ; Shock ; Streptococcus pneumoniae* ; Streptococcus* ; Virulence

No Abstract Available.
Cataract* ; Corneal Opacity*

For comparison of clinical classification of leprosy to histopathologic classification, a detailed histopathologic study, using hematoxylin and eosin stain and Ziehl-Neelsen stain, was done on 72 fresh uncomplicated cases of leprosy. The clinical classification was done using the criteria of Ridley and Jopling (1966), and the microscopic features were classified according to Ridley's(1974) definition. Clinical classification revealed that 8 of total 72 patients had tuberculoid(TT), 9 had borderline tuberculoid (BT), 5 had borderline(BB), 10 had borderline lepromatous.(BL), and 31 had lepromatous leprosy(LL). Nine patients were claasified as indeterminate(I) group. Histopathologic classification showed that 3 cases presented tuberculoid(TT), 10 presented borderline tuberculoid(BT), 4 presented borderline(BB), 9 presented borderline lepromatous(BL), 20 presented subpolar leprornatous(LLs), and 10 presented polar lepromatous(LLp) histopathologic characteristics, Sixteen cases were classified as indeterminate(I) leprosy by histopathologic findings. On comparison of clinical classification to histopathologic classification, the two were in consonance with each other in 50 cases(69.4%) and the disparity between them was noticed in 22 cases(30.6%). Among the 22 cases which showed disparity, there was a shift of one step either towards the tuberculoid or lepromatous end of the spectrum in 15 cases, and ihe remaining 7 cases were classified as indeterminate group beaause of nonspecific histopathologic changes.
Classification* ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Leprosy* ; Leprosy, Paucibacillary

No abstract available.
Liver* ; Mortality*

A follow-up study was made of 26 knees of 21 patients who underwent arthroscopic synovectomy between October 1982 and August 1983 in Catholic Medical College and Center. The patient's ages ranged from 3 to 66 years of age. There were 14 female patients and 7 male patients in this series. The follow-up period of all patients was a minimum of twelve months to a maximum of 20 months. The average follow-up of the whole group was 16.8 months. The abnormal findings were rated from 0 to 4 according to Marmors rating system. Final clinical evaluations of the patients were done according to the modified criteria of Sledge et al. The results were as follows; 1. Rheumatoid Arthritis Of 14 knees, 3 joints(21.4%) were rated “excellent”, 6(42.9%) were “good”, and 5(35.7%) were “fair”. There was no case of “unimproved”. 2. Juvenile Rheumatoid Arthritis The results of all 5 knees were satisfactory. Of 5 knees, 4 joints(80%) were rated excellent and one joint (20%) was good. 3. There were 3 knees of osteoarthritis, 3 knees of chronic synovitis and one knee of pigmented villonodular synovitis. Their final results were all satisfactory. Three joints were rated excellent and the other 3 joints were good. 4. Of 26 knees, as a whole, 10 joints (38.5%) were rated “excellent”, 11 joints (42.3%) were “good”, 5 joints (19.2%) were “fair” and no joint was “unimproved”. There were 5 recurrences of active synovial disease in this series, and these patients all were “classic” rheumatoid arthritis. But surprisingly the average patient in this group of recurrence did well even after recurrence. These patients all had less pain and effusion than before operation. 5. The major cause of unsatisfactory results other than recurrence of synovitis were articular degeneration (joint space narrowing) and patellofemoral osteoarthritis (4 knees). 6. A good range of motion with the shortest rehabilitation period can be expected if alternate flexion and extension splints are applied on alternate days for less than a week following the surgery. In conclusion, one may state that the arthroscopic synovectomy is worth considering for the treatment of various kinds of synovitis of the knee joint and when the rheumatoid process follows a favourahle course.
Arthritis, Juvenile ; Arthritis, Rheumatoid ; Female ; Follow-Up Studies ; Humans ; Joints ; Knee Joint ; Knee ; Male ; Osteoarthritis ; Range of Motion, Articular ; Recurrence ; Rehabilitation ; Splints ; Synovitis ; Synovitis, Pigmented Villonodular

The significance of the physical examination is controversial since Slocum and Larson first described the concept of rotatory instability of the knee. The findings of the physical examination of the 101 knees of 95 patients from 1982 to 1985 were compared with the operative findings. The results were as follows. 1. Valgus stress test a) The valgus stress test c the knee in extension was positive in 1) combined tear of medial collateral ligament, posterior oblique ligament, either anterior or posterior cruciate ligament, 2) avulsion fracture of medial collateral ligament and 3) extensive tear of medial capsular ligament. But the test was negative when the posterior oblique ligament was intact although the medial collateral ligament and the anterior cruciate ligament were torn. b) The valgus stress test c the knee in 30° flexion was positive in all cases of torn medial collateral ligament, But it was severer in cases of positive test in full extension. 2. The varus stress test in extension was positive when the anterior or posterior cruciate ligament was torn in addition to lateral collateral ligament and posterolateral capsule. 3. The Slocum test was negative, or positive only in neutral rotation in isolated tear of the anterior cruciate ligament. 4. The Ritchey-Lachman test was positive in all cases of torn anterior cruciate ligament. 5. The posterior drawer test could be positive in cases of intact posterior cruciate ligament. 6. The pivot shift test was negative in cases of torn medial collateral ligament and posterior oblique ligament although there was associated tear of the anterior cruciate ligament. 7. The flexion rotation drawer test was positive in all cases of torn anterior cruciate ligament although there was associated tear of the medial collateral ligament. The positive test didn't always mean anterolateral rotatory instability, 8. The reversed pivot shift test was positive in cases of posterolateral rotatory instability but it was negative in cases of associated tear of posteromedial capsule. 9. The drawback of external rotation drawer test was that it depended on subjective evaluation. 10. The rotation test was very good for the rotatory instability but it could not be used in bilateral injury and the anterolateral rotatory instability of isolated tear of anterior cruciate ligament.
Anterior Cruciate Ligament ; Collateral Ligaments ; Exercise Test ; Humans ; Knee ; Lateral Ligament, Ankle ; Ligaments ; Physical Examination ; Posterior Cruciate Ligament ; Tears

Comminuted fracture of the acetabulum in association with dislocation of the hip has aiways been a serious injury because of its protracted convalescent period and the permanent disability. Conventional open reduction, however, has contained much technical difficulties and its end result has usually been disappointing to both the patient and the surgeon. Recent concept is that total hip replacemet can be the primary choice of treatment in the management of such complicated injuries. In contemplating THR in this occasion, however, the acetabular defect secondary to its fracture-dislocation stands out as a primary source af cup loosening atter operation. A special consideration has been given in this respect and in five clinical cases the TMR with our modification was carried out with the following results. 1. In three cases of comminuted central fracture-dislocation of the hip, the gap and deformity of the fractured acetabulum was successfully corrected by inserting two pieces of T-shaped bone graft taken from the removed femoral head. 2. In another two cases of comminuted posterior fracture-dislocation of the hip, the posterior wall defect of the acetabulum was prepared by reduction of the fragments displaced and then temporary fixation with two Steinmann pins during the operative step of cup insertion. The pins could easily be removed after setting of the bone cement. 3. By applying this new modification, the THR surgery was successful and uneventful in all five cases with smooth postoperative courses.
Acetabulum ; Arthroplasty, Replacement, Hip ; Congenital Abnormalities ; Dislocations ; Fractures, Comminuted ; Head ; Hip ; Humans ; Transplants

PURPOSE: To evaluate US and CT characteristics of small renal cell carcinomas with diameter less than 3cm. MATERIALS AND METHODS: We retrospectively analysed US and CT findings of the small renal cell carcinomas which were surgically confirmed. We analysed echogenicity, peritumoral hypoechoic rim, intratumoral cysts on US. We analysed CT with viewpoints of tumor margin, growth pattern, renal contour change, attenuation on pre- and postcontrast scan, homogeneity, and perirenal changes. RESULTS: The US characteristics of the small renal cell carcinomas were hyperechogenicity(89%), peritumoral hypoechoic rim(66%) and intratumoral cysts(44%). They had relatively well-defined margin(90%), smooth and round contour(90%), endophytic growth pattern(65%), and outward bulging of renal contour(75%) on CT. They had iso- or high attenuation(87%) on precontrast CT, and were relatively homogeneous low-attenuated on postcontrast CT. CONCLUSION: The constellation of US and CT findings may be helpful in the diagnosis and understanding of the internal architecture of the small renal cell carcinomas.
Carcinoma, Renal Cell* ; Diagnosis ; Retrospective Studies

No abstract available.
Fertilization in Vitro* ; Fertilization*

PURPOSE: To analyze the imaging features of brain abscess. MATERIALS AND METHODS: MR studies of nine patients with surgically verified brain abscess were retrospectively reviewed. RESULTS: The shape of abscesses were round(n=6), multilobulated(n=2) or triangular(n=1). All lesions were located in corticomedullary junction and extended into white matter. On gadolinium-DTPA enhanced images, smooth rim-like(n=6) or irregular thick enhancement(n=3) of abscess wall was noted. Budlike projection from the abscess capsule was found in 4 cases. The signal intensity of abscess capsule was either hyperintense (n=5) or isointense(n=4) relative to white matter on Tl-weighted images, and hypointense(n=6), isointense (n=2) or mixed hypo and isointense(n=l) on T2-weighted images. Satellite nodules were found in 2 cases. PNS inflammation(n=2), meningitis(n=1), ventriculitis(=2) and subdural empyema(n=1) were associated CONCLUSION: The MR features of brain abscess included characteristic intensity of abscess capsule, budlike projection from the abscess wall, moderate amount of peripheral edema, satellite nodules, and associated meningitis, ventriculitis or PNS infection. The morphology of abscess wall was not specific for the diagnosis of brain abscess.
Abscess ; Brain Abscess* ; Brain* ; Diagnosis ; Edema ; Humans ; Meningitis ; Retrospective Studies