BACKGROUND: There are many reports showing the efficacy of polymerase chain reaction(PCR) for the diagnosis of Mycobacterium tuberculosis in sputum. but only few reports in extrapulmonary specimens. Because of the difficulty in establishing a diagnosis of tuberculosis in the extrapulmonary specimens there have been considerable interest in the development of a rapid sensitive diagnostic test that might be useful. Therefore we used PCR for detection of M. tuberculosis DNA in extrapulmonary specimens and compared the results of conventional acid-fast stain, culture methods and PCR assay. METHODS: Total of 63 clinical samples(10 cerebrospinal fluids, 12 pleural fluids, 1 pericardial fluid, 3 bone marrow aspirates, 1 ascitic fluid, 25 fine needle aspirates of lymph nodes, 7 urine, 1 stool and 3 tissue biopsies) in Ewha Womans University Tongdaemun hospital were analysed by the PCR. We performed the PCR using a species-specific M. tuberculosis DNA fragment(mtp 40 gene) as primers that was cloned and sequenced at recent and a 396-bp fragment was specifically amplified. We analyzed sensitivity and specificity of AFB culture and PCR for the diagnosis of extrapulomonary tuberculosis. RESULTS: The positivity of AFB smear, culture and PCR were 2(10%), 4(20%), 13(65%) out of total 20 cases diagnosed as clinically active extrapulmonary tuberculosis. respectively. All of 2 smear-positive samples and 2 of 4 culture-positive and smear-negative samples were PCR-positive. And 9 of 14 smear and culture negative specimens also gave detectable DNA products in PCR The specificity of PCR(95.4%) is compared with those of smear and culture(100.0%). CONCLUSIONS: This results suggest that the PCR assay is a sensitive and rapid diagnostic alternative to classical procedures for the diagnosis of extrapulmonary tuberculosis.
Ascitic Fluid ; Bone Marrow ; Cerebrospinal Fluid ; Clone Cells ; Diagnosis* ; Diagnostic Tests, Routine ; DNA ; Female ; Humans ; Lymph Nodes ; Mycobacterium tuberculosis ; Needles ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Sputum ; Tuberculosis*

No abstract available.
Humans ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn

Anisakiasis is a parasitic infectious disease caused by eating raw, infected fish. It causes severe abdominal pain-like acute abdomen, but not fatal. Anisakiasis was firstly reported by van Thiel et al. in 1960 in Netherlands and it has subsequently been reported in the Netherlands, Japan, the United states, Korea as well as other nations. Because Koreans like eating raw fish, the anisakiasis of the stomach was occasionally reported, but the case of severe gastric bleeding was very rare. So we report one case of gastric ulcer bleeding due to gastric anisakis larva proven by endoscopy and gastric resection.
Abdomen, Acute ; Anisakiasis* ; Anisakis ; Communicable Diseases ; Eating ; Endoscopy ; Hemorrhage* ; Japan ; Korea ; Larva ; Netherlands ; Stomach ; Stomach Ulcer* ; United States

BACKGROUND: Pulmonary thromboembolism is relatively frequent and potentially fatal. However, it is commonly misdiagnosed. The incidence of pulmonary thromboembolism is not decreasing despite advances in diagnosis and effective prophylatic measures. Its potential for significant sequela necessitates a prompt diagnosis and treatment. Unfortunately, there are many difficulties and problems regarding accurate diagnosis. There is a low prevalence of deep vein thrombosis and pulmonary thromboembolism in Korea and only few reports on this subject are available. METHOD: The clinical features of 36 patients, who were diagnosed with pulmonary thromboembolism at the Korea University medical center, were reviewed. RESULTS: 1) There was no significant difference in prevalence between men an women, and the mean age was 50.9 years in men 59.2 years in women. 2) The frequent causes of pulmonary thromboembolism were malignancies (22.2%), surgery (22.2%), and heart disease(8.2%). Specific causes were not identified in 33.3%. 3) The most common symptom was dyspnea(72.2%), and the most common sign was tachypnea(61.1%). 4) The EKG findings were normal in 28.6%, and S1Q3T3 pulmonale pattern in 25.7%, ST or QRS changes in others. 5) The chest X-ray findings indicated pulmonary infiltation in 37.5%, cardiomegaly in 15.6%, pleural effusion in 12.5%, and normal in 27.8%. The perfusion lung scan showed a high probability in 66.7%, and intermediate or low probability in 33.3%. 6) The pulmonary arterial pressure(PAP) in the high probability groups was 57.9mmHg with a higher mortality rate(35%). CONCLUSION: Pulmonary thromboembolism is not uncommon in Korea and its clinical features do not differ greatly from those reported in the literature. When pulmonary thromboemblism of unknown causes are diagnosed, a search for an occult malignancy is recommended. Rapid diagnosis and treatment are achieved when thromboemblism is suspected.
Academic Medical Centers ; Cardiomegaly ; Diagnosis ; Electrocardiography ; Female ; Heart ; Humans ; Incidence ; Korea ; Lung ; Male ; Mortality ; Perfusion ; Pleural Effusion ; Prevalence ; Pulmonary Embolism* ; Thorax ; Tomography, Spiral Computed ; Venous Thrombosis

The mineral content and width of bone can be determined noninvasively by “bone densitometer”, which measures the absorption by bone of a monoenergetic photon beam that originates in a radioactive source(Iodine-125 at 27.3 Kev). The intensity of the beam transmitted by the bone is measured by a scintillation detector. The bone mineral density is obtained from dividing the bone mineral content by bone width. Since Cameron and Sorenson, in 1963, first described the photon absorptiometry, many investigators have studied this method and applied it clinically. In order to determine the bone density of normal koreans, and compare it with that of fracture risk group, we measured the bone density of the distal one third of the nondominant radius in 152 normal persons(55 male, 97 female), and 54 patients(23 male, 31 female) having the risk of spontaneous fracture from the third to seventh decades. This data were also compared with those of normal Caucasians. The results were as follows. 1. The average bone densities(gm/cm2) of normal men from the third to the seventh decades were 0.773 ±0.055, 0.749 ±0.070, 0.770 ±0.060, 0.797 ±0.053, 0.664 ±0.126, respectively and those of normal women were 0.680 ±0.058, 0.680 ±0.036, 0.674 ±0.052, 0.608 ±0.084, 0.523 ±0.093, respectively. 2. The average bone densitied(gm/cm2) of fracture risk men from the third to seventh decades were 0.647 ±0.072, 0.719 ±0.050, 0.729 ±0.085, 0.699 ±0.064, 0.562 ±0.049, respectively and those of fracture risk women were 0.603 ±0.049, 0.061 ±0.021, 0.326 ±0.034, 0.494 ±0.045, 0.430 ±0.035, respectively. 3. There were statistically significantly differences in the bone densities between the normal population group and the fracture risk group. 4. The average bone densities(gm/cm2) of normal koreans were lower than those of normal Caucasians by 0.115 ±0.023 in male, and 0.091 ±0.005 in female. 5. We belive that bone densitometer is an effective tool in early detection and treatment in metabolic bone deseass including osteoporosis.
Absorptiometry, Photon ; Absorption ; Bone Density ; Female ; Fractures, Spontaneous ; Humans ; Male ; Methods ; Miners ; Osteoporosis ; Population Groups ; Radius ; Research Personnel

Seidel nail is one of locked humeral nail and Seidel himself reported excellent result in his preliminary report using his nail. But our early experience showed disappointing result with high rate of complications, So we reviewed our 16 cases of humeral shaft fracture with polytrauma treated with Seidel nail and studied anatomical fitness of the nail within the distal medullary space using CT scan. The most frequent complication was intraoperative fracture of the proximal humerus < 4 cases> and this seemed to be due to lateral placement of pilot hole. There were 3 cases of nonunion and these cases showed insufficient distal anchorage, either primarily or postoperatively. Anatomical fitness study showed insufficient spreading of nail flanges in 5 cases of distal canal width below 9mm and nonunion cases were in this group. Other problems of Seidel nail were technical difficulties due to occasionally incorrect proximal targeting device and frequent breakage of adaptor screw. Study of more cases may be needed to confirm the design problem of Seidel nail.
Humerus ; Multiple Trauma ; Tomography, X-Ray Computed

No abstract available.
Neurothekeoma* ; Scalp*

Granulomatous mycosis fungoides is an extremely rare and unusual histologic variant of mycosis fungoides. This form is clinically characterized by spontaneous resolution of ulcerated nodular lesions into poikiloderma. Histologically, a strong granulomatous component can obscure the underlying cutaneous lymphoma, which is frequently mistaken for non-neoplastic dermatitides or cutaneous sarcoidosis. We report a case of granulomatous mycosis fungoides occurring on the left cheek of 34-year-old man confirmed histologically with an aid of immunohistochemistry and clinical course (immediate response to PROMACE-CYTOBAM chemotherapy), with emphasis on differential diagnosis, along with a review of literature. This is the first documented report in the Korean literature.
Male ; Humans ; Diagnosis, Differential

No abstract available.
Fever ; Humans ; Still's Disease, Adult-Onset* ; Urticaria*

BACKGROUND: This study was performed to evaluate our experience on laparoscopic appendectomy. METHODS: Retrospective analysis was performed on 2,856 patients who had been operated by laparoscopic appendectomy under diagnosis of acute appendicitis at the Sung-Ae Hospital and Kwang-Myoung Sung-Ae Hospital from October 1991 to July 1998. RESULTS: Among 2,856 patients who had undergone laparoscopic appendectomy,2,379 patients (83.3%) were operated due to simple acute appendicitis, 275 patients (9.6%) due to perforated appendicitis. Operation time was 44.6 minutes for simple acute appendicitis and 60.3 minutes for perforated appendicitis. In perforated appendicitis, intra-peritoneal irrigation and drain insertion was performed. The length of hospital stay in patient with simple acute appendicitis was 3.7 days (5.82 days in conventional appendectomy) and patients with perfotrated appendicitis was 6.1 days (9.91 days in conventional appen-dectomy). Complications such as wound infection, intra-abdomen abscess, trocar site bleeding, subcutaneous emphysema developed in 43 (1.5%) patients (79/1,947, 4.5% in conventional appendectomy). In 202 (7.1%) patients, appendix was normal, but another diseases were detected, including acute pelvic inflammation, ovarian cyst, mesenteric lymphadenitis, enteritis, diverticulitis in order. CONCLUSION: Overall complication rate was lower in laparoscopic appendectomy compared with conventional appendectomy and the length of hospitalization of laparoscopic appendectomy was shorter. When the acute appendicitis is suspected, especially in the reproductive women, the laparoscopic approach would be better diagnostic and therapeutic value than conventional method. Therefore laparoscopic appendectomy would be replaced with conventional appendectomy.
Abscess ; Appendectomy* ; Appendicitis ; Appendix ; Diagnosis ; Diverticulitis ; Enteritis ; Female ; Hemorrhage ; Hospitalization ; Humans ; Inflammation ; Length of Stay ; Mesenteric Lymphadenitis ; Ovarian Cysts ; Retrospective Studies ; Subcutaneous Emphysema ; Surgical Instruments ; Wound Infection