BACKGROUND: Serologic markers are used to screen and diagnose the hepatitis B virus infection. In endemic area of hepatitis B, the coexistence of HBsAg and anti-HBs was frequently observed. This finding is unusual and difficult to interpret. In this study, we performed three molecular biologic assays-polymerase chain reaction (PCR), chemiluminescent molecular hybridization assay (CMHA), branched DNA (bDNA) nucleic acid hybridization assay- to detect HBV-DNA in the sera which showed both HBsAg and anti-HBs positivity. To define the patients` exact clinical conditions, we analysed the characteristics of the patients according to their diagnoses, other serologic markers and clinical findings. METHODS: HBsAg and anti-HBs were detected by EIA (Enzygnost, Behringwerke, Germany) from clinical specimens of Yonsei University College of Medicine Severance Hospital collected In the period between January 1996 and December 1996. Eighty three specimens from Severance Hospital and twenty two specimens from Health Care Center were randomly selected and were subjected to HBV PCR, HBV CMHA and HBV bDNA assay for the presence of HBV-DNA. RESULTS: The patients were arbitrarily divided into 4 groups on the basis of the optical density values of enzyme immunoassay results. Group I (high HBsAg and high antral-HBs) consisted of 6 cases; group II (high HBsAg and low anti-HBs) consisted of 70 cases, group III (low HBsAg and high anti-HBs) consisted of 1 case; group IV (low HBsAg and low antral-HBs) consisted of 6 cases. Among 83 cases, the positive rate was 51.8% (43 cases) using PCR method, 53.0% (44 cases) using CMHA, 60.2% (50 cases) using bDNA assay. HBeAg and anti-HBc IgM were helpful to predict the presence of HBV-DNA in the sera. CONCLUSIONS: More than half of the patients who showed both HBsAg and anti-HBs positivity were positive for HBV-DNA by molecular biologic methods. In contrast, no one whose serologic markers with only anti-HBc positivity with out HBsAg and anti-HBs positivity showed HBV-DNA positive in the sera from Health Care Center. Taken together, the management and follow-up of the patients of both HBsAg and anti-HBs positivity could be greatly aided by combined adoption of any one molecular biologic assay of HBY-DNA with other serologic markers such as HBeAg and anti-HBc IgM.
Biological Assay ; Branched DNA Signal Amplification Assay ; Delivery of Health Care ; Diagnosis ; DNA ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens* ; Hepatitis B virus ; Hepatitis B* ; Hepatitis* ; Humans ; Immunoenzyme Techniques ; Immunoglobulin M ; Nucleic Acid Hybridization ; Polymerase Chain Reaction

We experienced a case of transient right-sided heart failure after angioplasty of membranous obstruction of the inferior vena cava confirmed by sonography and an inferior vena cavogram. Angioplasty involved the use of a self-expandable metallic stent, but after successful recanalization of the obstruction , the patient became dyspneic. Chest radiography revealed mild cardiomegaly with pulmonary congestion, but this was resolved spontaneously. For the prevention of serious heart failure, we recommend preprocedural evaluation of cardiac function.
Angioplasty* ; Cardiomegaly ; Estrogens, Conjugated (USP) ; Heart Failure* ; Humans ; Radiography ; Stents ; Thorax ; Vena Cava, Inferior*

Several bills were proposed during the 20th and 21st National Assemblies to grant special judicial police powers to employees of the National Health Insurance Corporation (NHIC) to improve the low recovery rate of unfair profits collected by non-medical practitioner hospitals. The Ministry of Health and Welfare made a pre-announcement of legislation regarding the revision of the Enforcement Decree of the Medical Law, aiming to delegate certain enforcement responsibilities, including investigations into illegally established hospitals. This study discusses the contents and issues related to the bill, focusing on the revision of the Enforcement Decree of Medical Law and the bill proposed by the 21st National Assembly. Furthermore, it proposes improvements to address the challenges posed by non-medical practitioner hospitals.Current Concepts: We pointed out concerns regarding the bill to grant special judicial police powers to NHIC employees, such as the potential infringement of basic rights due to a lack of expertise among these special judicial police, a reversal of procedural thinking, challenges in identifying illegal hospitals, the appropriateness of granting investigative rights to NHIC employees, and the risk of abuse of these rights.Discussion and Conclusion: We propose strengthening the establishment, operations, and supervision of medical corporations; introducing a preliminary monitoring system for the establishment of medical institutions through branches of medical personnel organizations; and implementing a leniency program.

PURPOSE: To evaluate the effects of cheap tinted contact lenses on corneal swelling and ocular surface inflammation, compared to hydrogel and silicone hydrogel contact lenses. METHODS: Forty eyes of 20 New Zealand white rabbits were randomly assigned to 4 groups. Two types of tinted contact lenses, hydrogel lenses, and silicone hydrogel lenses were each applied to 10 rabbit eyes. Corneal thickness and tear lactate dehydrogenase (LDH) activity were measured at 1 and 4 days after contact lens wear, and the inflammation of ocular surface was scored at 4 days after contact lens wear. The internal surface of the cheap tinted lens was examined with a scanning electron microscope to compare the surface quality between the tinted and non-tinted area. RESULTS: Although the corneal swelling of the silicone hydrogel lens group was significantly lower than the other 3 lens groups after contact lens wear (p<0.01), the common hydrogel lens group was not different from the 2 tinted contact lens groups (p>0.1). Tear LDH activity at 1 and 4 days after contact lens wear showed no significant difference among the 4 groups (p>0.29). The scores of ocular surface inflammation in the 2 tinted contact lens groups were greater than the hydrogel and silicone hydrogel lens groups (p=0.03). The scanning electron microscope revealed the internal surface of the tinted area in the tinted contact lens was coarse and irregular though the surface of the non-tinted area was relatively smooth. CONCLUSIONS: Regarding corneal swelling and tear LDH activity, the cheap tinted contact lenses used in Korea were not significantly different from the common hydrogel contact lenses. However, tinted contact lenses showed a greater tendency to provoke ocular surface inflammation than other lenses. The coarse and irregular surface of the tinted area in the tinted contact lens appears to play a role in provoking severe ocular surface inflammation.
Contact Lenses ; Electrons ; Eye ; Hydrogel ; Inflammation ; Korea ; L-Lactate Dehydrogenase ; Rabbits ; Silicones

Experinece in the management of 74 patients with delayed traumatic intracranial hemorrhage(DTICH) of 474 head injury from January 1996 to December 1996 is poresented with emphasis on the incidence, occurring time, risk factors and outcome. The incidence of DTICH was 15.6% of all hospitalized head-injury patients. After an injury, every patient had an immediate computerized tomography(CT) scan to diagnose intracranial pathology and then CT follow-up was carried out according to intial CT finding and reurological deficit. The lesion was almost occurred in patients with initial abnormal CT finding(85.1%). 82.4% of DTICH were noted within 72 hours after injury. The delayed epidural hematoma and intracerebral hemorrhage were almost noted in first 72 hours(>90%), but the delayed subdural hemorrhage was found after a time interval varying from 6 hours to 10 days. So we strongly recommend CT follow-up in 4-8hour, 24-72hour, and then 7th day after head injury, especially in patients with initial abnormal CT findings. The risk factor of the delayed lesion was not hypotension, hypoxia, and consciousness level, but age of patients and the initial CT finding. The development of DTICH was not heralded by neurological deterioration. The prognosis of DTICH was not worse than non-DTICH. The patient with delayed subdural hemorrhage was better than the patient with non-delayed lesion(including hemorrhage and normal CT finding).
Anoxia ; Cerebral Hemorrhage ; Consciousness ; Craniocerebral Trauma* ; Follow-Up Studies ; Head* ; Hematoma ; Hematoma, Subdural ; Hemorrhage ; Humans ; Hypotension ; Incidence ; Intracranial Hemorrhages* ; Pathology ; Prognosis ; Risk Factors

Wear of polyethylene liner and osteolysis appear to be topical problems after long-term follow-up in total hip arthroplasty(THA). Age and activity of patients, manufacturing procedure of polyethylene liner, thickness of the liner, position of acetabular cup, and material of artificial femoral head have of effects on the degree of wear. In addition, conformity, congruency and micromotion between liner and metal cup are likely to be related to the wear. The purpose of this study is 1) to determine the stress caused by contact between metal and polyethylene components, 2) to evaluate the effects of conformity, congruency, and fixation between metal and polyethylene components, on contact stress in acetabular cups and 3) to identify the design parameters of the commercial acetabular cup within the constraints imposed by the overall functional requirements of total joint replacement. The specimens applied to six different commercial cups made in five companies. The methods was performed on dynamic test and static test to rely on load conditions, estimated the gap between the components through LM. The results showed H-G II cup had the most excellent congruency because of the narrowest interval between two components.
Acetabulum ; Head ; Hip ; Humans ; Joints ; Osteolysis ; Polyethylene*

BACKGROUND: The increased use of peripheral blood stem cells (PBSC) to reconstitute hematopoiesis needs accurate methods to control the quality. Transplantation centers often rely on CD34+ cell quantitation by flow cytometry to ensure adequacy of hematopoietic progenitor cell collection. Because of variation in interpretation, a lack of interlaboratory proficiency studies, and no generally accepted methodology, comparison of CD34 positive cell data among centers is difficult. To assess the variability of CD34 assay, a multicenter survey involving 4 samples and 14 major laboratories was conducted to compare CD34 positive cell quantitation. METHODS: Fifty-three laboratories were asked to participate and participants were surveyed for their cell processing and staining methods as well as instrumentation, software, and analysis parameters. Four cord blood samples from delivered placenta were shipped by overnight carrier to fourteen participating laboratories for analysis. Total leukocyte count, total mononuclear cell count, CD34 positive cell percentage of leukocytes, absolute CD34 positive cell count were assayed items. RESULTS: Fourteen laboratories were recruited. Six laboratories used only CD34 monoclonal antibody and five laboratories included one more additional antibody (CD45 or CD14) in their procedure. Two laboratories used a commercial kit (ProCOUNTTM). One laboratory analyzed with indirect immunofluorescent assay. Coefficient of variants of CD34 positive cell percentage of leukocytes of each sample were 74.1%, 100.0%, 73.1%, 70.0%, that of absolute CD34 positive cell count were 64.2%, 84.7%, 79.5%, 75.8%, respectively. CONCLUSIONS: We observed an alarming variation among the CD34 positive cell counts reported from different laboratories. An effort to standardize the procedure, reporting policy, quality control as well as to make close communications with physicians and laboratorians should be made for proper management of the patients.
Cell Count ; Fetal Blood ; Flow Cytometry ; Hematopoiesis ; Hematopoietic Stem Cells* ; Humans ; Leukocyte Count ; Leukocytes ; Placenta ; Quality Control ; Ships ; Stem Cells

OBJECTIVE: To investigate the life of persons with C4 tetraplegia in the community residence. METHOD: This study was designed as a personal interview survey using the questionnaires for the general characteristics, Craig Handicap Assessment and Reporting Technique (CHART), Diener's satisfaction with life scale, and Rosenberg self esteem scale. The subjects were 15 persons with C4 tetraplegia. RESULTS: Among 15 persons, six were married, three of them were married after the injury. Five persons reported being employed, thirteen persons used computers. The number of cases for remodeling their houses were 13. Twelve persons reported being 'glad to be alive'. Their Diener's satisfactionof life scale was 16.6 (slightly dissatisfied). Rosenberg self esteem scale was 23.3. The CHART showed the following scores: physical independence 46, mobility 56, occupation 30, social integration 89, and economic self sufficiency 68. Diener's satisfaction with life scale of the subjects were significantly correlated with that of their caregiver (p=0.006). CONCLUSION: The life of the individual with C4 tetraplegia in the community was more active than expected, considering their substantial physical limitation. Therefore, appropriate post-discharge planning should be included in inpatient rehabilitation program for the C4 tetraplegics.
Caregivers ; Humans ; Inpatients ; Occupations ; Quadriplegia* ; Quality of Life ; Surveys and Questionnaires ; Rehabilitation ; Self Concept

No abstract available.
Amebiasis* ; Diabetes Mellitus* ; Humans ; Kidney* ; Liver*

PURPOSE: To evaluate the frequency of peritumoral bone marrow(BM) edema accompanying benign giant celltumor(GCT) of the appendicular bone by magnetic resonance(MR) imaging and to correlate MRI findings with those ofplain radiography and bone scintigraphy. MATERIALS AND METHODS: Eighteen cases of pathologically proven benignGCT of the appendicular bone were retrospectively analyzed using MR images, plain radiographs and bonescintigrams. A plain radiograph was available in 15 cases, and a scintigram in six. Marrow edema was defined asperitumoral signal changes which were of homogeneous intermediate or low signal intensity(SI) on T1WI and high SIon T2WI, relative to the SI of normal BM, and homogeneous enhancement on Gd-DTPA-enhanced T1WI. The transitionzone, sclerotic margin and aggressiveness of the lesion were assessed on the basis of plain radiographs. BM edemaseen on MR images was correlated with plain radiographic and scintigraphic findings. RESULTS: 1. Peritumoral BMedema was seen on MR images in 10 of 18 cases (55.5%). 2. In 8 of 15 cases for which plain radiographs wereavailable, MR imaging revealed BM edema. In six of these eight, transition zone was wide, while in two it wasnarrow. Six of seven patients without marrow edema showed a wide transition zone, and in one this was narrow.There was significant correlation between BM edema shown by MR imaging and the transition zone seen on plainradiographs (x2, p<0.05). But The aggressiveness shown by plain radiographs correlated only marginally, while thepresence of sclerotic rim did not correlate. 3. All six cases for which a bone scintigram was available showed anextended uptake pattern. In five of the six, MR imaging revealed edema. CONCLUSION: Peritumoral BM edema wasfrequently seen (55.5%) in the GCTs of appendicular bone ; it was more often shown in association with a widetransition zone by plain radiographs.
Bone Marrow* ; Edema* ; Giant Cell Tumors* ; Giant Cells* ; Humans ; Magnetic Resonance Imaging ; Radiography ; Radionuclide Imaging ; Retrospective Studies