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*

No abstract available.
Alopecia ; Humans ; Male

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.
Child* ; Giant Cell Tumors* ; Giant Cells* ; Humans ; Tendons*

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

A clinical study of 71 cases of pulmonary tuberculosis that had had surgical resection during the period of 7 years and 6months from January 1989 to June 1996 in National Masan Tuberculosis Hospital. The results were as follows : 1. The ratio of male to female was 3.7 : 1 and in the age incidence the fourth decade was 22%, the third decade 15%. 2. Although medical treatment was performed for more than 3 to 6 months, preoperatively the conversion failure rate of positive sputum to negative state was 66.2%(47 cases). Of the failure cases, multiple-drug-resistant(MDR) patients were 41 cases(87.2%). 3. In MDR group, preoperatively conversion failure rate was 71.9%. 4. From the view of indication for lung resection on the radiographic finding, cavitary lesions were 43 cases(60.6%), destroyed lung lesions were 24 cases(33.8%). 5. The incidence of postoperative complication was 28.2%(20 cases). All cases were MDR group and the most common of complication was tuberculosis spreading. 6. In bilateral lesion, incidence of postoperative tuberculosis spreading was 25%(7 cases). Of the 7 cases, there was the cavitary lesion in 6 cases(86.7%). 7. Total conversion rate of AFB positive sputum to negative state related to resectional sugery was 76.6% and in MDR group conversion rate of AFB positive sputum to negative state was 73.2%. Conversion rate of MDR group with bilateral lesion was the lowest(60%). Conversion rate of drug-sensitivity group was 100% regardeless of lesions site. In conclusion, despite of long-standing medical treatment, it is difficult to converse sputum-positive to negative state in multiple-drug resistance patients and that increases postoperative complications such as tuberculosis relapse as a lack of appropriate drugs postoperatively. Postoperative conversion rate of sputum-positive to negative state was decreased in multiple-drug resistance patients. Because multiple-drug resistance patients have increased due to several factors in Korea, it is important to prevent spreading of multiple-drug resistnce patients through the aggressive operative treatment. When the first medical therapy is fail or drug-resistance is found, operative treatment should be considered with the secondary medical therapy. The operation should be aggressively attempted even though at first medical treatment if indicated.
Female ; Hospitals, Chronic Disease ; Humans ; Incidence ; Korea ; Lung ; Male ; Postoperative Complications ; Recurrence ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary*

Primary cutaneous adenoid cystic carcinoma is a rare, slow-growing malignancy that consists of basaloid cells. It characteristically follows an indolent course but has a high tendency to recur locally after excision. We experienced a recurrent primary adenoid cystic carcinoma of the abdomen in a 69-year-old female. It had recurred locally three times over 13 years despite repeated excisions. Wide spreading and perineural invasion of tumor cells were identified during Mohs micrographic surgery, and it seemed to be related to the repeated recurrences. Herein, we report this rare case with clinical and histological features of a recurrent nature.
Abdomen ; Adenoids ; Aged ; Carcinoma, Adenoid Cystic ; Cicatrix ; Female ; Humans ; Mohs Surgery ; Recurrence

Hypotrichosis simplex is a descriptive term of hair loss without other ectodermal or systemic abnormalities. Hypotrichosis simplex with non-familial and generalized types has been seldom reported. A 30-year-old man visited our clinic complaining of scalp hair loss since birth. There was no hair on the arms, axillae and legs. He had relatively scanty eyebrows and pubic hairs. None of his family members had known health problems or any hereditary disease. Hair shaft examination based on electron microscopy did not reveal any structural abnormalities. Microscopic examination of a scalp biopsy specimen showed a reduced number of hair follicles with vellus hairs replacing terminal hairs. Herein we report a rare and interesting case of non-familial generalized hypotrichosis simplex.
Adult ; Arm ; Axilla ; Biopsy ; Ectoderm ; Eyebrows ; Genetic Diseases, Inborn ; Hair ; Hair Follicle ; Humans ; Hypotrichosis ; Leg ; Methylmethacrylates ; Microscopy, Electron ; Parturition ; Polystyrenes ; 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