One hundred and thirty-eight strains of Mycobacterium tuberculosis isolated from the 7th nationwide tuberculosis prevalence survey in 1995 were subjected to the restriction fragment length polymorphism (RFLP) analysis using IS6110 probe to define the representative fingerprinting patterns of Korean strains of M. tuberculosis and to evaluate the usefulness of DNA fingerprinting in tracing the transmission link of M. tuberculosis. Among 138 strains, 129 different IS6l10 RFLP types were identified. The number of bands in IS6110 RFLP types diversed from 1 to 20, and the majority (75%) was 9 to 14 bands. The RFLP patterns of 8 out of 15 strains isolated from the follow-up survey of one and half year later after the 7th national TB prevalence survey were unchanged when compared with previous RFLP patterns. Fifteen (11%) out of 138 strains were grouped in 6 IS6110 clusters; 2 with 10 copies, 2 with 12 copies, 1 with 14 copies, and 1 with 17 copies. These clusters were unable to be subclassified by IS1081 or (GTG) probes except one cluster by pTBN12 probe. The transmission links of 2 clusters were deducible; one from household and another from neighborhood, but those of remaining clusters were unclear because they had no contact one another. The results suggest that vigorous transmissions in tuberculosis are still progressing in Korea.
Dermatoglyphics ; DNA Fingerprinting* ; DNA* ; Family Characteristics ; Follow-Up Studies ; Korea ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymorphism, Restriction Fragment Length ; Prevalence* ; Residence Characteristics ; Tuberculosis*

Alkaptonuria (AKU, OMIM: 203500) is a rare autosomal recessive disorder of tyrosine metabolism due to a defect of enzyme activity, homogentisate 1,2-dioxygenase (HGD). The patients with AKU initially presented with dark urine discoloration, and ochronosis and arthritis develop after third decades of life. With advances of Internet resources, web-based health seekers for rare disease are increasing. Here, we report the case of an 18-year-old boy with AKU who visited our center due to dark black urine based on self-diagnosis via web searching of this rare condition. Compound heterozygous mutations in HGD gene, IVS5+3A>C and IVS12+6T>C were identified and both of mutations were detected in his parents. Our case illustrates the utility of publicly available Internet resources for diagnosis of rare disease.
Adolescent ; Alkaptonuria* ; Arthritis ; Databases, Genetic ; Diagnosis ; Homogentisate 1,2-Dioxygenase ; Humans ; Internet* ; Male ; Metabolism ; Ochronosis ; Parents ; Rare Diseases* ; Tyrosine

PURPOSE: Interest in peptic ulcer in children has been relatively low because the disease is rarer in children than in adults and there were restrictions in the application of endoscopy to children, but the recent development of pediatric endoscopy is activating research on pediatric peptic ulcer. Thus, this study compared the H. pylori infection rate and clinical and endoscopic findings among pediatric patients diagnosed with peptic ulcer. METHODS: We analyzed retrospectively 58 pediatric patients for whom whether to be infected with H. pylori was confirmed selected out of pediatric patients diagnosed with gastric ulcer or duodenal ulcer through upper gastrointestinal endoscopy at the Department of Pediatrics of Gachon University Gil Hospital during the period from January 2002 to December 2007. A case was considered H. pylori positive if H. pylori was detected in the Giemsa stain of tissue or the results of UBT (urea breath test) and CLO (rapid urease test) were both positive. RESULTS: Of the pediatric patients, 37 were infected with H. pylori and 21 were not. The H. pylori infection rate increased with aging and the result was statistically significant (p<0.05). However, H. pylori infection was not in a statistically significant correlation with sex, chief complaint, and gastroduodenal ulcer (p>0.05). CONCLUSION: H. pylori infection increased with aging, but was not significantly correlated with gastroduodenal ulcer. Further research may need to examine prospectively the relation between H. pylori and gastroduodenal ulcer in the Incheon area.
Adult ; Aging ; Azure Stains ; Child ; Duodenal Ulcer ; Endoscopy ; Endoscopy, Gastrointestinal ; Helicobacter ; Helicobacter pylori ; Humans ; Pediatrics ; Peptic Ulcer ; Retrospective Studies ; Stomach Ulcer ; Urease

OBJECTIVES: Gastrectomy with lymph node dissec tion is the standard treatment for early gastric can cer(EGC). However, patients who have high risks demand modifications in surgical treatment for EGC. Recently, endoscopic mucosal resection(EMR) has become accepted in many institutions as a treatment for cancerous mucosal lesions of the stomach. Thus we investigated the efficacy and safety of EMR prospectively in the patients with EGC who have high risks in surgery and those with premalignant lesions. METHOD: Twenty-five patients were treated with EMR, thirteen were EGC and twelve were premalignant lesions such as tubular adenoma, severe dysplasia. We used standard snare method and endoscopic mucosal resection using a band ligation kits(EMRL). RESULTS: The complete resection rate at the first step of EMR was 100%(12/12) in premalignant lesions, 76.9%(10/13) in EGC. Of three EGC resected incomple tely at the first step, one patient was treated by surgery and two patients underwent the third step of EMR. The final complete resection rate was 92%(23/25) and it was 100%(12/12) in the premalignant lesions, 84.6%(11/13) in EGC. The final complete resection rate in according to the methods was 100%(5/5) by standard snare method, 75%(6/8) by EMRL. As pathologic results, all cases of EGC were limited to the mucosa. No serious complications such as perforation, major bleeding were encountered. CONCLUSION: We consider that EMR is effective and safe in treatment of the patients with EGC who have high risks in surgery and those with premalignant lesions.
Adenoma ; Gastrectomy ; Hemorrhage ; Humans ; Ligation ; Lymph Nodes ; Mucous Membrane ; Prospective Studies ; SNARE Proteins ; Stomach ; Stomach Neoplasms*

BACKGROUND: Long-term maintenance of smoking cessation is important to reduce smoking related diseases. There are few studies that evaluated long-term maintenance and related factors. For effective cessation treatment, we analyzed the relapse pattern after cessation and related factors. METHODS: We selected people who visited a health care center more than two times between January 1995 and December 2006 and who have succeeded in cessation after the first visit. Telephone survey was done and their medical records was analyzed. A total of 308 people whose medical records corresponded to the results of the telephone survey were finally included and analyzed. RESULTS: The mean follow-up duration was 112 months and the mean age of the first visit was 47.9 years. The median maximum duration of abstinence was 5.50 years, and the annual hazard ratio of relapse was about 2.5-4.2% from two to seven years of duration of abstinence. Mean age of smoking onset was 22.9 years, the mean smoking duration was 24.5 years, and the mean smoking amount per a day was 20.0 cigarettes. In single-variate analysis, the total number of cessation success, the age of smoking onset, the mean smoking duration, the mean smoking amount per day, the cessation method, the reason for trying cessation were related with the long-term cessation maintenance. In multivariate analysis, the total number of success for cesstion, the reason for trying cessation, the cessation method, the mean number of cigarettes per day were related. CONCLUSION: The experience of relapse, the motive of cessation and self-willingness were shown to be important for long-term maintenance of smoking cessation.
Delivery of Health Care ; Follow-Up Studies ; Medical Records ; Multivariate Analysis ; Recurrence ; Smoke ; Smoking ; Smoking Cessation ; Telephone ; Tobacco Products

PURPOSE: The Mycobacterium tuberculosis complex comprises M. tuberculosis, M. bovis, M. bovis bacillus Calmette-Guerin (BCG) and M. africanum, and causes tuberculosis in humans and animals. Identification of Mycobacterium spp. and M. tuberculosis complex to the species level is important for practical use in microbiological laboratories, in addition to optimal treatment and public health. MATERIALS AND METHODS: A novel multiplex PCR assay targeting a conserved rpoB sequence in Mycobacteria spp., as well as regions of difference (RD) 1 and RD8, was developed and evaluated using 37 reference strains and 178 clinical isolates. RESULTS: All mycobacterial strains produced a 518-bp product (rpoB), while other bacteria produced no product. Virulent M. tuberculosis complex strains, M. tuberculosis, M. bovis and M. africanum, produced a 254-bp product (RD1), while M. bovis BCG, M. microti and nontuberculous mycobacteria produced no RD1 region product. Additionally, M. tuberculosis and M. africanum produced a 150-bp product (RD8), while M. bovis and M. bovis BCG produced a 360-bp product (deleted form of RD8). M. microti and nontuberculous mycobacteria produced no RD8 region product. This assay identified all Mycobacterium spp. and all M. tuberculosis complex strains to the species level. CONCLUSION: The multiplex PCR assay of the present study could be implemented as a routine test in microbiology laboratories, and may contribute to more effective treatment and surveillance of tuberculosis stemming from the M. tuberculosis complex.
Animals ; Cattle ; Classification/methods ; DNA Primers ; Genes, Bacterial ; Humans ; Multiplex Polymerase Chain Reaction/*methods ; Mycobacterium/classification/genetics/*isolation & purification ; Mycobacterium tuberculosis/classification/genetics/*isolation & purification ; Species Specificity

BACKGROUND: Guillain-Barre syndrome is defined as a recognizable clinical entity that is characterized by rapidly evolving symmetric limb weakness, the loss of tendon reflexes, absent or mild sensory signs, and variable autonomic dysfunctions. This study evaluated the clinical and electrophysiological findings retrospectively. MATERIALS AND METHODS: Forty-five patients with Guillain-Barre syndrome, who were admitted to the Yeungnam University Hospital for six years from Jan. 1994 to Dec. 1999 were investigated. The correlation between the clinical manifestation and the electrophysiological study was evaluated. RESULTS: The male to female ratio was 1.8: 1 and there was a peak seasonal incidence in the winter. A preceding illness was noted in 66.7% of cases, and an upper respiratory tract infection was the most common one. The most common clinical manifestations were a loss of tendon reflex and ascending muscle weakness and paralysis. The cerebrospinal fluid examinations revealed, albuminocytologic dissociation in 33 cases (73.3%). Intravenous immunoglobulin therapy was performed in 29 cases (64.4%). The sequential electrophysiological abnormalities were most marked at 2 to 4 weeks after onset. At that time the most significant change was a decrease in the compound muscle action potential amplitude. These 45 patients with Guillain-Barre syndrome were subclassified using the clinical and electrophysiological data. CONCLUSION: The result in this study, concured with other research on the clinical and electrophysiological data of Guillain-Barre syndrome. However, an extensive and dynamic investigation is necessary to determine the reason for the peak seasonal incidence in winter.
Action Potentials ; Cerebrospinal Fluid ; Extremities ; Female ; Guillain-Barre Syndrome* ; Humans ; Immunization, Passive ; Incidence ; Male ; Muscle Weakness ; Paralysis ; Reflex, Stretch ; Respiratory Tract Infections ; Retrospective Studies ; Seasons

OBJECTIVE: This study was undertaken to evaluate that noise-exposed workers have been appropriately selected for the special periodic health examination and that pure-tone audiometry has been correctly applied and the results of these have been properly analyzed. METHODS: We obtained health examination data of noise-exposed workers from 48 special periodic health examination agencies. The data consisted of special periodic health examination results and audiograms that had performed examination during the latter half of 1998. We analysed the appropriateness of the subject selection for the second special periodic health examination of noise-exposed workers, the method of pure-tone audiometry, and the evaluation of audiogram. RESULTS: The screening performance rate is 67.65% in the special periodic health examination of noise-exposed workers. Although 34.29 persons per agency should have had a second examination according to our criteria, only 18.44 persons were actually examined. So a third of subjects were omitted. The air and bone conduction performance rate by each frequency is 75.71 %. 24.29 % persons did not have a bone conduction and were evaluated only by air conduction. The correct use rate of symbols(right, left-unmasked AC, masked AC, unmasked BC, and masked BC) recommended by ASHA(American Speech-Language-Hearing Association) was 70.36 %. Generally air conduction threshold is equal to or higher than bone conduction threshold. In the reverse case, especially if the gap is more than 10 dB(BC-AC > 10), this is considered to be incorrect. When we applied this criteria, the result indicated that it was correct in 75.46 %. The performance rate of air masking was 15.03 %, and bone masking was 26.21 %. 7 among 48 agencies diagnosed NIHL(Noise-Induced Hearing Loss) only by air conduction, 8 performed air masking and 13 did bone masking. When compared with ISO Standard(1964) and Ministry of Labor Standard, the results of evaluation(D1, D2) on hearing loss according to hearing loss type and threshold were rather low. CONCLUSIONS: Hearing Quality Assurance Program about periodic special examination agencies and examiners will continue to be needed and also the evaluation of hearing loss should be performed and controlled using accurate criteria. This will reduce the error among examiners and results in individuals by means of a standard that is capable of being accurate and reliable.
Audiometry, Pure-Tone* ; Bone Conduction ; Hearing ; Hearing Loss ; Humans ; Masks ; Mass Screening ; Noise

Background : Gene transfer with vectors derived from murine retroviruses is restricted to cells which are proliferating and synthesizing DNA at the time of infection. Accordingly, selective introduction of genes encoding for susceptibility to otherwise nontoxic drugs (suicide genes) into proliferating tumor may be used to treat cancer. We investigated the efficacy of in vitro transduction of neuroblastoma cell with the herpes simplex-thymidine kinase (HSV-tk) gene followed by administration of the antiviral drug ganciclovir. METHODS: The LNC/tK vector was transfered in vitro into mouse Neuro 2a cell lines (ATCC) and the transduced cell lines were selected in G-418, 500microgram/ml, for 14 days. Onex104 cells were cultured in 96 well culture plates in increasing concentrations of ganciclovir for 72 hours. The sesitivity to ganciclivir of these HSV-tk transduced, G-418 selected cells was measured with MTT assay RESULTS: The survival of HSV-tk transduced 1x104 neuro 2a cell lines is 103+/-3.5%, 68+/-4.2%, 54+/-3.8%, 17+/-2.6%, 13+/-3.1% at the concentration of 0, 0.1, 1.0, 10, 20microgram/ml ganciclovir, respectively. And the survival of HSV-tk not transduced 1x104 neuro 2a cell lines is 100+/-4.5%, 97+/-5.6%, 104+/-3.5%, 106+/-3.8%, 101+/-4.2%. CONCLUSION: We concluded that in vitro transduction of neuroblastoma cell with the herpes simplex-thymidine kinase gene followed by administration of the antiviral drug ganciclovir is very effective.
Animals ; Cell Line* ; DNA ; Ganciclovir ; Mice ; Neuroblastoma* ; Phosphotransferases ; Retroviridae ; Zidovudine*

Background : Gene transfer with vectors derived from murine retroviruses is restricted to cells which are proliferating and synthesizing DNA at the time of infection. Accordingly, selective introduction of genes encoding for susceptibility to otherwise nontoxic drugs (suicide genes) into proliferating tumor may be used to treat cancer. We investigated the efficacy of in vitro transduction of neuroblastoma cell with the herpes simplex-thymidine kinase (HSV-tk) gene followed by administration of the antiviral drug ganciclovir. METHODS: The LNC/tK vector was transfered in vitro into mouse Neuro 2a cell lines (ATCC) and the transduced cell lines were selected in G-418, 500microgram/ml, for 14 days. Onex104 cells were cultured in 96 well culture plates in increasing concentrations of ganciclovir for 72 hours. The sesitivity to ganciclivir of these HSV-tk transduced, G-418 selected cells was measured with MTT assay RESULTS: The survival of HSV-tk transduced 1x104 neuro 2a cell lines is 103+/-3.5%, 68+/-4.2%, 54+/-3.8%, 17+/-2.6%, 13+/-3.1% at the concentration of 0, 0.1, 1.0, 10, 20microgram/ml ganciclovir, respectively. And the survival of HSV-tk not transduced 1x104 neuro 2a cell lines is 100+/-4.5%, 97+/-5.6%, 104+/-3.5%, 106+/-3.8%, 101+/-4.2%. CONCLUSION: We concluded that in vitro transduction of neuroblastoma cell with the herpes simplex-thymidine kinase gene followed by administration of the antiviral drug ganciclovir is very effective.
Animals ; Cell Line* ; DNA ; Ganciclovir ; Mice ; Neuroblastoma* ; Phosphotransferases ; Retroviridae ; Zidovudine*