No abstract available.
Child* ; Giant Cell Tumors* ; Giant Cells* ; Humans ; Tendons*

BACKGROUND: Recently, serologic techniques for tuberculosis have been developed and some of them, which are focusing on detection of serum antibodies mainly directed against specific 38-kDa Mycobacterium tuberculosis, have already been introduced into the market. In this study, diagnostic significance of a new serologic test(ELISA kit) for pulmonary tuberculosis was evaluated. METHODS: Serologic test with newly developed ELISA kit was performed upon 474 individuals, who include 333 active pulmonary tuberculosis patients, 80 healthy cases, and 61 tuberculosis contact cases. This serologic test was based on the ELISA technique and designed to detect antibodies to mixed complex antigens including 38-kDa, which were developed by Erume Biotech Co.,Seoul.Active pulmonary tuberculosis was diagnosed by sputum AFB smear and culture methods. RESULTS: The seropositivities using this ELISA kit were 82.1% and 73.6% in smear-positive and negative groups among active pulmonary tuberculosis, respectively. And, it also showed that seronegativities were 97.5% and 85.2% in healthy and contact groups, respectively. As a whole, the results of our study suing the ELISA kit as a diagnostic methiod for pulmonary tuberculosis showed 80.0% sensitivity for active pulmonary tuberculosis, 97.5% specificity, 96.1% positive predictive value, and 65.0% negative predictive value when the prevalence of tuberculosis in the samples was 60.1%. CONCLUSION: Our results reveal that the detection of antibody its reaction with 38-kDa antigen of M.tuberculosis is not sufficient to be accepted as single diagnostic method for pulmonary tuberculosis. However, they suggest that ELISA kit may be considered as an adjunctive test to standard diagnostic techniques of pulmonary tuberculosis.
Antibodies ; Enzyme-Linked Immunosorbent Assay* ; Humans ; Mycobacterium tuberculosis* ; Mycobacterium* ; Prevalence ; Sensitivity and Specificity ; Serologic Tests* ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary*

Neonatal Gaves disease is a relatively rare condition due to transplacental passage of Thyroid-stimulating antibody(TSAb) from a mother with active or inactive Graveses disease or autoimmune thyroiditis. A 11-day-old female newborn was referred to our department of pediatrics from a local clinic because of low level T4(3.55microg/dl) concurrent with high level TSH (501.74uIU/ml) on the 5th day neonatal metabolic screening. But, our repeated laboratory data showed very high serum T4(59.6microg/dl), T3(1,600ng/dl), suppressed TSH(0.43uIU/ml), and the presence of TSH receptor antibody. Her mother was treated with propylthiouracil(PTU) for Graves disease during pregnancy. Therefore, we thought it was a delayed-onset neonatal hyperthyroidism, because the fetal thyroid gland was initially suppressed by antithyroid drug taken during pregnancy. After initiating antithyroid drug therapy for the hyperthyroid nature, TSH levels became elevated again, while thyroid hormone levels decreased. Maternal and infant blood samples at the 23th day after birth were examined for serum autoantibodies directed towards the TSH receptor(Thyrotropin-binding inhibitory immunoglobulin:TBII, Thyroid-stimulating antibody:TSAb, Thyroid-stimulating blocking antibody:TSBAb) and high levels of TBII and TSAb were detected. About 2 months after birth, TBII and TSAb decreased within normal limit, and then we could stop antithyroid medication in safety. We report here a case of neonatal Graveses disease with very high level of T4 and T3, but firstly presented as hypothyroid nature on neonatal screening because of the maternally transferred antithyroid drug, PTU.
Autoantibodies ; Drug Therapy ; Female ; Graves Disease ; Humans ; Hyperthyroidism ; Infant ; Infant, Newborn ; Mass Screening ; Mothers ; Neonatal Screening ; Parturition ; Pediatrics ; Pregnancy ; Receptors, Thyrotropin ; Thyroid Gland ; Thyroiditis, Autoimmune

No abstract available.
Alopecia ; Humans ; Male

Compared to cutaneous benign fibrous histiocytoma (BFH), deep-seated BFH is very rare and poorly recognized. Both cutaneous and deep-seated BFH are usually asymptomatic. We herein report a 25 year-old woman who presented with a painful mass in her foot that was poorly controlled by analgesics and associated with walking difficulty. After preoperative ultrasonographic evaluation, the mass was completely excised and histologic exam showed spindle cells loosely arranged in storiform architecture, with CD34-, desmin-, S-100-, focal CD68+, vimentin+, smooth muscle actin+, and factor XIIIa+. The patient was diagnosed with deep-seated BFH based on the histologic, radiologic and intraoperative findings.
Analgesics ; Female ; Foot ; Histiocytoma, Benign Fibrous ; Humans ; Muscle, Smooth ; Walking

In the 1960s, Sir John Charnley introduced to clinical practice his concept of low-friction total hip arthroplasty (THA). Although early designs were plagued by poor performance and even failure, there have been steady advances in implant designs, biomaterials, surgical techniques and an understanding of the biomechanical restoration of the hip; these advances have contributed to improvements in implant survival and clinical outcomes of THA in the past three decades. With improved wear resistance and mechanical reliability, a potential to last for at least 25 to 30 years are now available for THA. In this review, we focus on the evolution of THA and review current controversies and future directions of this procedure based on a single surgeon's 29-year of experience at a single institution.
Arthroplasty, Replacement, Hip ; Biocompatible Materials ; Hip

BACKGROUND: Treatment outcome with only chemotherapy for multi-drug resistant tuberculosis is usually considered not to be satisfactory. However, the combined therapy of chemotherapy with surgical treatment has been producing higher sputum AFB negative conversion and longer survival rates, and this treatment strategy is expected to be a set-up for the patients with multi-drug resistant tuberculosis. MATERIAL AND METHOD: A retrospective review was performed with the medical records and laboratory findings in 49 patients with multi-drug resistant tuberculosis of 130 patients who underwent pulmonary resection for pulmonary tuberculosis between January 1995 and December 1999 at National Masan Tuberculosis Hospital. RESULT: A mean number of the resistant drugs was 4.5 with a mean age of 35 years. Cavitary lesions on plain chest x-ray were shown in 43 patients of 49(87.8%). Thirty one had positive sputum cultures preoperatively(63.3%). Operative techniques were as follows; 12 pneumonectomies, 28 lobectomies, 7 lobectomies with segmentectomies or wedge resections, one wedge resection and a cavernoplasty. Sputum AFB negative conversion rate was 93.5 % with continuous postoperative chemotherapy. There was no death after operation. Air leakage over a week, postoperative bleeding and wound disruption were developed as postoperative complications. CONCLUSION: We experienced the higher effectiveness of postoperative chemotherapy with pulmonary resection on multi-drug resistant tuberculosis. Although there are several different ideas about operative indications, postoperative drug regimens and length of postoperative medications, pulmonary resection should be considered actively as a effective combination measure with chemotherapy to give a treatment for multi-drug resistant pulmonary tuberculosis.
Drug Therapy ; Hemorrhage ; Hospitals, Chronic Disease ; Humans ; Mastectomy, Segmental ; Medical Records ; Pneumonectomy ; Postoperative Complications ; Retrospective Studies ; Sputum ; Survival Rate ; Thorax ; Treatment Outcome ; Tuberculosis, Multidrug-Resistant* ; Tuberculosis, Pulmonary ; Wounds and Injuries

BACKGROUND: Nowadays, although its clinical value remains controversial institutions utilize hair mineral analysis. Arguments about the reliability of hair mineral analysis persist, and there have been evaluations of commercial laboratories performing hair mineral analysis. OBJECTIVE: The objective of this study was to assess the reliability of intra-laboratory and inter-laboratory data at three commercial laboratories conducting hair mineral analysis, compared to serum mineral analysis. METHODS: Two divided hair samples taken from near the scalp were submitted for analysis at the same time, to all laboratories, from one healthy volunteer. Each laboratory sent a report consisting of quantitative results and their interpretation of health implications. Differences among intra-laboratory and interlaboratory data were analyzed using SPSS version 12.0 (SPSS Inc., USA). RESULTS: All the laboratories used identical methods for quantitative analysis, and they generated consistent numerical results according to Friedman analysis of variance. However, the normal reference ranges of each laboratory varied. As such, each laboratory interpreted the patient's health differently. On intra-laboratory data, Wilcoxon analysis suggested they generated relatively coherent data, but laboratory B could not in one element, so its reliability was doubtful. In comparison with the blood test, laboratory C generated identical results, but not laboratory A and B. CONCLUSION: Hair mineral analysis has its limitations, considering the reliability of inter and intra laboratory analysis comparing with blood analysis. As such, clinicians should be cautious when applying hair mineral analysis as an ancillary tool. Each laboratory included in this study requires continuous refinement from now on for inducing standardized normal reference levels.
Hair ; Hematologic Tests ; Minerals ; Reference Values ; Scalp

Pseudoxanthoma elasticum is a multiorgan disorder, characterized by ectopic mineralization of elastic fibers of skin, eyes, and cardiovascular system. The dermatologic manifestations include laxity of skin, as well as cutis laxa-like wrinkling especially on both axillae. The classic forms of pseudoxanthoma elasticum are due to mutations in the ATP-binding cassette subfamily C member 6 (ABCC6) gene, a presumed transmembrane transporter expressed primarily in the liver and the kidneys. Recent case reports of mutations of gamma-glutamyl carboxylase (GGCX) gene describe associations with vitamin K-dependent coagulation factor deficiency and pseudoxanthoma elasticum as well. A 23-year old woman presented with laxity on both axillae and trunk and a history of vitamin K-dependent coagulation factor deficiency, diagnosed 2 years ago. Fragmented and markedly degenerated elastic fibers with calcium deposition were identified on biopsy specimens. Herein, we report a case of autosomal recessive pseudoxanthoma elasticum combined with vitamin K-dependent coagulation factor deficiency.
Axilla ; Biopsy ; Blood Coagulation Factors ; Calcium ; Carbon-Carbon Ligases ; Cardiovascular System ; Elastic Tissue ; Eye ; Female ; Genes, vif ; Humans ; Kidney ; Liver ; Pseudoxanthoma Elasticum ; Skin ; Vitamins

Darier's disease is a genetic disorder of keratinization with autosomal dominant inheritance. Its appearance is usually in the form of greasy, crusted, keratotic yellow-brown papules and plaques found particularly on seborrheic areas of the body. However, there are some clinical variants showing atypical skin lesions. Here we report an unusual case of Darier's disease, which mainly showed prominent comedonal papules over the face.
Darier Disease ; Keratins ; Skin ; Wills