BACKGROUND: Outbreaks of multidrug-resistant tuberculosis(MDR-TB) are caused by the low rate of treatment response due to limitation in number of available drugs and high rates of adverse drug side-effects. This study analysed the risk factors for MDR-TB patients, who did not respond to treatment, with an aim to improve the rate of treatment response. METHODS: Retrospective study of 111 MDR-TB patients at National Mokpo Tuberculosis Hospital from Jan. 1996 to Dec. 1998 was made. The patients were separated into tow groups ; group I comprised of patients who were treated successfully and group II comprised of those were not treated successfully. In order to analyze the risk facotrs for treatment faulure, differences between the two groups were compared and the confidence limit regarding the results were tested using an independent t-test, chi-square test and a Fisher's exact tets. RESULTS: The treatment failure rate of MDO-TB patients was 32% (36 patients), and treatment success rate 68%(75 patients). This study found no significant difference between two groups in terms of age, sex, family history, extent of the disease on the chest X-ray, the number of sensitive drugs in the treatment regimen, and the number of sensitive bactericidal drugs in the treatement regimen (p>0.05). However, a past history of pulmonary tuberculosis, cavitary lesions on the chest X-ray, the number of tretaments, the number of resistant drugs and the number of drugs used showed a significant difference(p<0.05). CONCLUSION: The rate of treatment failure in MDR-TB was increased by a past history of pulmonary tuberculosis, cavitary lesions on the chest X-ray, the number of treatments, the number of resistant drugs and the number of drugs used. For improving the treatment response of MDR-TB, every effort should be made to reduce the drug resistance caused by failure of the first treatment.
Disease Outbreaks ; Drug Resistance ; Hospitals, Chronic Disease ; Humans ; Jeollanam-do ; Retrospective Studies ; Risk Factors* ; Thorax ; Treatment Failure* ; Tuberculosis, Multidrug-Resistant ; Tuberculosis, Pulmonary

The aim of this study was to determine whether there are quantitative changes in the mechanoreceptors in the anterior cruciate ligament of unstable knee with injured medial articular cartilage or medial ligament. Twenty specimens of anterior cruciate ligament were obtained from medial articular cartilage injury group and medial ligament injury group, respectively. Forty anterior cruciate ligaments of the other side of knee were used as controls. The ligaments were transected and stained with a modified gold-chloride method. Mechanoreceptors were located almost exclusively in the periligamentous synovial tissue. The results were as follows; 1. Three kinds of mechanoreceptors were found at the surface of each ligament beneath the synovial membrane. 2. The type 2 mechanoreceptor was more common than any other types in all groups. 3. In the medial articular cartilage injury group, the number of mechanoreceptor was significantly decreased and morphologically degradated with synovial degeneration than the control group. The same findings were noted in the medial ligament injury group(P<0.003). 4. There was no statistical difference between the two experimental groups in numher of the mechanoreceptor. In conclusion, the mechanoreceptor of the anterior cruciate ligament of unstable knee with injured medial articular cartilage and ligament in the rabbit were decreased in its numher and were degradated morphologically than the control group. And it was suggested that reduced proprioception in unstable knee might he an another cause of development of osteoarthritis.
Anterior Cruciate Ligament* ; Cartilage, Articular* ; Knee ; Ligaments* ; Mechanoreceptors* ; Osteoarthritis ; Proprioception ; Synovial Membrane

Biomechanically, the posterior cruciate ligament has been considered the basic stabilizer in the knee, So a torn cruciate ligament should be sutured as soon as possible, otherwise within a few weeks it will undergo resorption, making suture impossible. Currently available reconstructive procedures of the posterior cruciate ligament are often inadequate. We have performed 6 cases of the reconstruction of the posterior cruciate ligament using medial meniscus. The results were as follows; 1. Functionally all cases were improved and objectively 5 cases(83.3% ) among them were achieved stability of the knee rather than preoperative condition. 2. Reconstruction of the posterior cruciate ligament using medial meniscus is technically simple and reliable and can therefore be recommended. But further investigation is necessary to answer question regarding the long term results.
Knee ; Ligaments ; Menisci, Tibial ; Posterior Cruciate Ligament ; Sutures

OBJECTIVE: To investigate the basal bone mineral density(BMD)s of the lumbar spine and femur of patients with endometriosis, and the changes of BMDs and biochemical bone markers after 6 months of gonadotropin releasing hormone(GnRH) agonist treatment. METHODS: The initial BMDs of 35 women with endometriosis were measured by dual energy x-ray absorptiometry at department of obstetrics & gynecology Yongsan Hospital, College of Medicine, Chung Ang University from April 1996 to May 1999. 19 patients of these group was repeatedly measured after 3.6mg subcutaneous depot injection of goserelin(Zoladex) every 4 weeks for 24 weeks. Osteocalcin and Deoxypyridinoline were measured before goserelin treatment, at 3 months, and at 6 months completion of goserelin treatment. RESULTS: Patients with endometriosis did not show the significant difference in mean BMD of lumbar spine and femur in comparison with age matched normal women. Patients treated with goserelin for 6 months showed 0.064+/-0.030g/cm2(5.56%) decrease of BMD in lumbar spine, 0.038+/-0.040g/cm2(3.85%) decrease in femur neck, 0.055+/-0.047g/cm2(6.10%) decrease in Ward triangle, 0.041+/-0.031g/cm2(5.19%) decrease in femoral trochanter. These data had statistical significance(p<0.001). At first 3 months and on completion of 6 months goserelin treatment, there were increase of 66.1%, 122.3% in serum osteocalcin respectively, and increase of 35.2%, 39.6% in urine deoxypyridinoline respectively, compared with pretreatment value. CONCLUSION: From these results, it is concluded that the BMDs of patients with endometriosis were normal, and after 6 months GnRH agonist treatment, bone loss was 3.85%-6.10%, and the values of biochemical bone markers were increased.
Absorptiometry, Photon ; Bone Density* ; Endometriosis* ; Female ; Femur ; Femur Neck ; Gonadotropin-Releasing Hormone* ; Gonadotropins ; Goserelin ; Gynecology ; Humans ; Obstetrics ; Osteocalcin ; Spine

A retrospective review was performed in 33 knees of 30 patients who had undergone arthroscopic debridement for degenerative osteoarthritis of the knee. The mean age of the patients at operation was 55 years and the mean follow-up after operation was 15 months. We divided the knec:s into 2 groups; meniscectomy group (23 knees) and non-meniscectomy group (10 knees). The preoperative radiographic findings were divided into 3 groups according to the classification systern by Lotke et al. The postoperative results were evaluated using the nine-point scale by Baumgaertner et al. Our study was conducted to: 1) assess the overall efficacy of arthroscopic debridement, 2) compare the results between the. Meniscectomy group and nonmeniscectomy group, and 3) identify the relationship between the preoperative radiographic findings and out- come at the final follow-up time. Overall excellent or good results were ac.hieved in 22 knees (67%) and the preoperative radiographic findings correlated with the outcome at the final follow-up time. But the results in the meniscectomy and non-meniscectomy poups showed no significant differences statistically. We believe that arthroscopic debridement is an effective option of treatments for mild I:o moderate degenerative arthritis of the knee after failure of conservative measures.
Classification ; Debridement* ; Follow-Up Studies ; Humans ; Knee* ; Osteoarthritis* ; Retrospective Studies

Cortical dysplasia is a cause of intractable epilepsy and a candidate for surgical resection to control epileptic attacks. The neuronal cytomegaly and balloon cell change are the diagnostic hallmarks of cortical dysplasia. Little research has been performed about the normal-sized dysplastic neuron which has complex arborizing dendrites and lacks in its polarity. The aim of this study was to define the histopathologic characteristics of the neurons in cortical dysplasia. Twelve cases of cortical dysplasia who underwent partial lobectomy for intractable seizures were selected and immunohistochemical staining for NF-M/H, MAP2, tau, and ubiquitin was performed. The perikarya and dendrite of dysplastic neurons were more intensely labeled with antibodies for the high and medium molecular weight neurofilament proteins (NF-M/H) than normal neurons. Immunoreactivity with the MAP2 antibody expressed mainly within the somatodendritic regions was present in the dysplastic or normal neurons without any significant difference in intensity. The complex arborizing dendrites of dysplastic neurons were easily identified due to pronounced immunoreactivity within the somatodendritic regions. Immunoreactivity with the primary antibody against tau and ubiquitin was present in the normal-looking neurons as well as the dysplastic neurons. This study suggests that the dysplastic neurons in cortical dysplasia are accompanied by changes of cytoskeletal neurofilaments, and the immunohistochemical stains for NF-M/H, MAP2, tau, and ubiquigin are useful to detect them.
Antibodies ; Coloring Agents ; Dendrites ; Epilepsy ; Malformations of Cortical Development* ; Molecular Weight ; Neurofilament Proteins ; Neurons ; Seizures ; Ubiquitin

Recurrent dislocation of the peroneal tendon is infrequent but often the injury is a disabling one, and the result of conservative treatment is unsatisfactory. Dislocation of these tendons may be the result of a congenitally shallow groove in the lateral malleolar or of a complete abscence of the groove and the dislocation may be present at birth or may be caused by trauma. We are reporting one case of bilateral recurrent dislocation of the peroneal tendons with- out any history of trauma in which disturbed superior peroneal retinaculum was reconstructed by transposition of the calcsneofibular ligament to the lateral side of the peroneal tendons. The calcaneal insertion of the calcaneofibular ligament was mobilised with a small bone block and reinserted in its bed after the transposition. After a follow up of 13 months, the result was satisfactory.
Dislocations ; Follow-Up Studies ; Lateral Ligament, Ankle ; Ligaments ; Parturition ; Tendons

Two cases of giant cell tumor of bone diagnosed by fine needle aspiration cytology are described. Case 1 was a 28-year-old male who had pain sense for one year at the right distal thigh. His radiologic finding revealed a destructive cortical lesion with soft tissue extension at medial side of epiphysis of the distal femur. Case 2 was a 21-year-old female complaining pain at left distal forearm for eight months and showed a well-demarcated expansile osteolytic lesion with multiseptation, and cortical destruction at epiphysis and metaphysis of the left distal radius on the X-ray. Fine needle aspiration of each lesion was performed. The aspirate of the case 1 revealed moderate cellularity, which was composed of scattered giant cells of osteoclastic type and small round to oval monotonous stromal cells in large areas. Giant cells were evenly distributed in single or small groups and had irregular but abundant cytoplasms with 10 to 20 nuclei in the center. The nuclei showed ovoid shape, fine granular chromatin, and a small but conspicuous nucleolus. Stromal cells were dispersed in isolated pattern or sometimes aggregated in clusters and showed the same nuclei as those of giant cells and scanty cytoplasms. Comparing to case 1, case 2 had a more translucent abundant cytoplasm in the giant cells and more spindled stromal cells. All two cases revealed neither nuclear atypism nor increased abnormal mitoses in both giant and stromal cells, suggesting no evidence of malignancy. Thereafter the lesions were treated with excision and curettage, and histologically confirmed as giant cell tumors of the bone.
Adult ; Biopsy, Fine-Needle ; Chromatin ; Curettage ; Cytoplasm ; Epiphyses ; Female ; Femur ; Forearm ; Giant Cell Tumor of Bone ; Giant Cell Tumors ; Giant Cells ; Glomerulonephritis* ; Humans ; Hypertensive Encephalopathy* ; Magnetic Resonance Imaging* ; Male ; Mitosis ; Osteoclasts ; Radius ; Stromal Cells ; Thigh ; Young Adult

We report a case of disseminated epidermolytic acanthoma in a 69-year-old male who presented numerous, small dark brown verrucous papules on both popliteal fossae, inguinal areas, and abdomen. Although each lesion clinically resembled seborrheic keratosis, light microscopic examination revealed features of epidermolytic hyperkeratosis.
Abdomen ; Acanthoma* ; Aged ; Humans ; Hyperkeratosis, Epidermolytic ; Keratosis, Seborrheic ; Male

Fractures of the metacarpal and phalanx of the hand are common occurances and bony union usually occurs without difficulties. If complication of the metacarpal and phalangeal fracture of the hand occurred, it causes significant functional deficit. The authors have reviewed 92 patients, 121 cases of metacarpal and palangeal fracture of the crushed hand which were treated with internal fixation with/without open reduction in the deparment of orthopaedic surgery in Holy Family Hospital from Jan. 1985 to Dec. 1989. The authors obtained the following results ; 1. The incidence of nonunion and delayed union was 12.4% (15/121 cases). 2. The criteriae of nonunion and delayed union are progressive angulation at fracture site after removal of implant, lack of bony union evidence in the radiography more than 12 weeks after injury, tenderness and pain on motion at fracture site and gross pseudomotion. 3. Nonunion and delayed union occurred more commonly in phalangeal fractures, shaft fractures, severely traumatized fractures (open fractures, marked displaced fractures, comminuted fractures and fractures had associated injuries in the same hand) and under-reduced fractures after internal fixation. 4. Mean TAM (total active motion) range at last follow up was 94.5°in thumb and 186.6°in finger and that of nonunion and delayed union cases was 89°in thumb and 153.5°in finger.
Fingers ; Follow-Up Studies ; Fractures, Comminuted ; Hand ; Humans ; Incidence ; Radiography ; Thumb